新型冠状病毒肺炎相关肝损伤研究进展

崔浩; 梁静; 向慧玲

doi:10.3969/j.issn.1001-5256.2022.04.039

新型冠状病毒肺炎相关肝损伤研究进展

DOI: 10.3969/j.issn.1001-5256.2022.04.039

崔浩^{1, 2},
梁静^{1, 2, , ,},
向慧玲²

1.
天津医科大学三中心临床学院，天津 300170
2.
天津市第三中心医院消化肝病科，天津 300170

基金项目:

天津科技重大专项与工程重大疾病防治 (19ZXDBSY00030)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：崔浩负责拟定写作思路，查阅文献，撰写论文；向慧玲提出指导性意见并参与支持性工作；梁静负责修改及指导撰写文章并最后定稿。

详细信息

通信作者:
梁静，haolele77@sina.com

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出版历程
- 收稿日期: 2021-12-01
- 录用日期: 2021-12-31
- 出版日期: 2022-04-20

Research advances in coronavirus disease 2019-related liver injury

Hao CUI^{1, 2},
Jing LIANG^{1, 2
, ,
,},
Huiling XIANG²

1.
The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China
2.
Department of Hepatology, Tianjin Third Central Hospital, Tianjin 300170, China

Research funding:

Tianjin Science and Technology Plan Project (19ZXDBSY00030)

More Information

Corresponding author: LIANG Jing, haolele77@sina.com(ORCID: 0000-0001-5114-9030)

摘要

摘要: 新型冠状病毒肺炎的大流行对全球的公共卫生安全造成了巨大威胁及挑战，并改变了医疗配置的优先性。在新型冠状病毒肺炎的临床诊治中，可以观察到相当比例的患者发生肝损伤，尤其是重症或危重症患者。本文总结新型冠状病毒肺炎致肝损伤的流行病学、机制、临床特征及治疗，希望可对临床医生的决策和优化治疗提供帮助。
- 新型冠状病毒肺炎 /
- 肝功能不全 /
- 药物性肝损伤 /
- 治疗学
Abstract: The coronavirus disease 2019 (COVID-19) pandemic has brought great threats and challenges to global public health and has changed the priorities of medical resource allocation. A considerable proportion of patients with liver injury is observed during the clinical diagnosis and treatment of COVID-19, especially in those with a severe or critical illness. This article summarizes the epidemiology, mechanism, clinical features, and treatment of liver injury caused by COVID-19, in order to help clinicians with decision making and treatment optimization.
- Coronavirus Disease 2019 /
- Hepatic Insufficiency /
- Drug Induced Liver Injury /
- Therapeutics

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表 1 各地区COVID-19相关肝损伤患者主要临床特征

Table 1. Main clinical characteristics of patients with COVID-19 related liver injury in various regions

第一作者	时间	地区	样本量(例)	年龄(岁)	男性占比[例(%)]	重症患者占比[例(%)]	有基础肝病占比[例(%)]	肝功能异常项目及占比
Guan^[2]	2020.4	中国(多中心)	1099	47(35~58)	640(58.2)	173(15.7)	23(2.1)	ALT(21.3%)；AST(22.2%)；TBil(10.5%)；LDH(41.0%)
Cai^[3]	2020.9	中国深圳	417	47(34~60)	198(45.3)	85(20.38)	21(5.04)	ALT(12.9%)；AST(18.23%)；TBil(23.19%)；ALP(4.55%)；GGT(16.31%)
Huang^[4]	2020.2	中国武汉	41	49	30(73.0)	13(31.7)	1(2.4)	AST(37%)；LDH(73%)
钱志平^[5]	2020.3	中国上海	324	51(15~88)	167(51.5)	26(8.0)	90(27.8)	ALT(15.7%)；ALP(1.2%)；INR(0.6%)
龙丹^[6]	2020.7	中国湖北	201	7~96	93(46.3)	28(13.9)		ALT/AST(18.4%)；TBil(0.5%)
Richardson^[7]	2020.5	美国(多中心)	5700	63(0~107)	3437(60.3)			ALT(39.0%)；AST(58.4%)
Bloom^[8]	2021.3	美国	60	57	39(65.0)		4(7.0)	ALT/AST/ALP/TBil至少有一项生化异常(69%)
注：LDH，乳酸脱氢酶。

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