2019新型冠状病毒肺炎肝功能损伤的临床特征和影响因素分析

Clinical features and influencing factors for coronavirus disease 2019-related liver injury

目的分析2019新型冠状病毒肺炎相关肝功能损伤情况及影响因素,为临床治疗提供参考。方法纳入山东省胸科医院收治的2019新型冠状病毒肺炎病例68例,分析肝功能损伤患者的临床特点及影响因素。结果68例确诊病例中,轻型、普通型患者56例,出现肝功能损伤22例;重型、危重型患者12例,出现肝功能损伤11例。肝功能损伤组患者体重指数、乳酸脱氢酶(LDH)、α羟基丁酸脱氢酶(HBDH)显著高于肝功能正常组(P<0.05),淋巴细胞计数显著低于肝功能正常组(P<0.05)。多因素分析:超重或肥胖、重型、危重型是肝功能损伤的独立危险因素(OR=0.324,95%CI:0.110~0.956;OR=0.085,95%CI:0.010~0.731)。结论超重或肥胖、重型、危重型是影响2019新型冠状病毒肺炎相关肝功能损伤的独立危险因素,在治疗过程中应加强对超重或肥胖、重型、危重型者肝功能指标检测、评估和治疗。

Objective To investigate the clinical features and influencing factors for coronavirus disease2019(COVID-19)-related liver injury,and to provide a reference for clinical treatment.Methods A total of 68 patients with COVID-19 who were admitted to Shandong Provincial Chest Hospital were enrolled,and their clinical features and related influencing factors were analyzed.Results Among the 68 patients with confirmed COVID-19,56 had mild-or common-type COVID-19(among whom 22 had liver injury)and 12 had severe-or critical-type COVID-19(among whom 11 had liver injury).Compared with the patients with normal liver function,the patients with liver injury had significantly higher body mass index,lactate dehydrogenase,andα-hydroxybutyrate dehydrogenase(P<0.05)and a significantly lower lymphocyte count(P<0.05).The multivariate analysis showed that overweight/obesity(odds ratio[OR]=0.324,95%confidence interval[CI]:0.110~0.956)and severe/critical type(OR=0.085,95%CI:0.010~0.731)were independent risk factors for liver injury.Conclusion Overweight/obesity and severe/critical type are independent risk factors for COVID-19-related liver injury,and it is necessary to strengthen the measurement,evaluation,and treatment of liver function parameters in patients with overweight/obesity and severe/critical-type COVID-19.