The intra and extracellular pathways of hepatic injury by coronavirus disease 2019(COVID-19)are still being studied.Understanding them is important to treat this viral disease and other liver and biliary tract disorde...The intra and extracellular pathways of hepatic injury by coronavirus disease 2019(COVID-19)are still being studied.Understanding them is important to treat this viral disease and other liver and biliary tract disorders.Thus,this paper aims to present three hypotheses about liver injury caused by COVID-19:(1)The interactions between severe acute respiratory syndrome coronavirus 2 spike protein and membrane receptors in the hepatocyte;(2)The dysbiosis and"gutliver axis"disruption in patients with serious clinical presentations of COVID-19;and(3)The inflammatory response exacerbated through the production of interleukins such as interleukin-6.However,despite these new perspectives,the pathophysiological process of liver injury caused by COVID-19 is still complex and multifactorial.Thus,understanding all these variables is a challenge to science but also the key to propose individualized and effective patient therapies.展开更多
Background Lupus hepatitis is yet to be characterized based on its clinical features and is often difficult to differentially diagnose from other liver diseases. We aimed to elucidate clinical, histopathological and i...Background Lupus hepatitis is yet to be characterized based on its clinical features and is often difficult to differentially diagnose from other liver diseases. We aimed to elucidate clinical, histopathological and immunopathological features of lupus hepatitis and to evaluate primarily the effectiveness of liver immunopathological manifestations on differential diagnosis of lupus hepatitis from other liver diseases. Methods A retrospective study was performed to analyze clinical features of lupus hepatitis in 47 patients out of 504 inpatients with systemic lupus erythematosus （SLE） in First Affiliated Hospital of Sun Yat-sen University, China from May 2006 to July 2009, and to evaluate the association between lupus hepatitis and SLE activity. Additionally, liver histopathological changes by hematoxylin and eosin （HE） staining and immunopathological changes by direct immunofluorescence test in 10 lupus hepatitis cases were analyzed and compared to those in 16 patients with other liver diseases in a prospective study. Results Of 504 SLE patients, 47 patients （9.3%） were diagnosed to have lupus hepatitis. The prevalence of lupus hepatitis in patients with active SLE was higher than that in those with inactive SLE （11.8% vs. 3.2%, P 〈0.05）. The incidence of hematological abnormalities in patients with lupus hepatitis was higher than that in those without lupus hepatitis （40.4% vs. 21.7%, P 〈0.05）, such as leucocytes count （2.92x109/L vs. 5.48x109/L）, platelets count （151x109/L vs. 190x109/L）, serum C3 and C4 （0.34 g/L vs. 0.53 g/L; 0.06 g/L vs. 0.09 g/L） （P 〈0.05）; 45 of 47 （95.7%） lupus hepatitis patients showed 1 upper limit of normal （ULN） 〈serum ALT level 〈5 ULN. The liver histopathological features in patients with lupus hepatitis were miscellaneous and non-specific, similar to those in other liver diseases, but liver immunopathological features showed positive intense deposits of complement lq in 7/10 patients with lupus hepatitis and negative complement lq deposits in all patients with other liver diseases （Fisher＇s exact test, P=-0.011）. Conclusions Lupus hepatitis was not infrequent in active SLE patients which would be one of the indices indicating SLE activity. Positive intense deposit of complement lq in liver may be a characteristic immunopathological feature of lupus hepatitis, which provides a new way to differentially dia qnose lupus hepatitis from other liver diseases.展开更多
目的探讨白芍总苷片与糖皮质激素联合治疗系统性红斑狼疮肝损害的临床疗效,为提高该病治疗效果提供参考.方法收集医院2013-06/2015-06 92例系统性红斑狼疮肝损害患者作为研究对象,依据随机对照组表法分为联合组与对照组,各46例.对照组...目的探讨白芍总苷片与糖皮质激素联合治疗系统性红斑狼疮肝损害的临床疗效,为提高该病治疗效果提供参考.方法收集医院2013-06/2015-06 92例系统性红斑狼疮肝损害患者作为研究对象,依据随机对照组表法分为联合组与对照组,各46例.对照组给予常规糖皮质激素治疗,联合组给予白芍总苷片与糖皮质激素联合治疗,观察两组患者治疗总有效率、肝功能改善状况以及不良反应.结果联合组总有效率高于对照组(93.5%v s73.9%),差异有统计学意义(P<0.05).治疗后联合组ALT、γ-GT、AST均明显的低于对照组,(31.7±7.4 vs 62.4±10.5)、(21.7±4.8 vs35.7±5.8)、(88.4±9.1 vs 121.6±10.7),组间差异有统计学意义(P<0.05).联合组治疗不良反应发生率明显的低于对照组(8.7%vs23.9%),差异有统计学意义(P<0.05).结论系统性红斑狼疮肝损害患者在常规糖皮质激素治疗上加用白芍总苷片治疗效果明显,显著改善患者肝功能,且不良反应少,安全性高,值得应用推广.展开更多
文摘The intra and extracellular pathways of hepatic injury by coronavirus disease 2019(COVID-19)are still being studied.Understanding them is important to treat this viral disease and other liver and biliary tract disorders.Thus,this paper aims to present three hypotheses about liver injury caused by COVID-19:(1)The interactions between severe acute respiratory syndrome coronavirus 2 spike protein and membrane receptors in the hepatocyte;(2)The dysbiosis and"gutliver axis"disruption in patients with serious clinical presentations of COVID-19;and(3)The inflammatory response exacerbated through the production of interleukins such as interleukin-6.However,despite these new perspectives,the pathophysiological process of liver injury caused by COVID-19 is still complex and multifactorial.Thus,understanding all these variables is a challenge to science but also the key to propose individualized and effective patient therapies.
文摘Background Lupus hepatitis is yet to be characterized based on its clinical features and is often difficult to differentially diagnose from other liver diseases. We aimed to elucidate clinical, histopathological and immunopathological features of lupus hepatitis and to evaluate primarily the effectiveness of liver immunopathological manifestations on differential diagnosis of lupus hepatitis from other liver diseases. Methods A retrospective study was performed to analyze clinical features of lupus hepatitis in 47 patients out of 504 inpatients with systemic lupus erythematosus （SLE） in First Affiliated Hospital of Sun Yat-sen University, China from May 2006 to July 2009, and to evaluate the association between lupus hepatitis and SLE activity. Additionally, liver histopathological changes by hematoxylin and eosin （HE） staining and immunopathological changes by direct immunofluorescence test in 10 lupus hepatitis cases were analyzed and compared to those in 16 patients with other liver diseases in a prospective study. Results Of 504 SLE patients, 47 patients （9.3%） were diagnosed to have lupus hepatitis. The prevalence of lupus hepatitis in patients with active SLE was higher than that in those with inactive SLE （11.8% vs. 3.2%, P 〈0.05）. The incidence of hematological abnormalities in patients with lupus hepatitis was higher than that in those without lupus hepatitis （40.4% vs. 21.7%, P 〈0.05）, such as leucocytes count （2.92x109/L vs. 5.48x109/L）, platelets count （151x109/L vs. 190x109/L）, serum C3 and C4 （0.34 g/L vs. 0.53 g/L; 0.06 g/L vs. 0.09 g/L） （P 〈0.05）; 45 of 47 （95.7%） lupus hepatitis patients showed 1 upper limit of normal （ULN） 〈serum ALT level 〈5 ULN. The liver histopathological features in patients with lupus hepatitis were miscellaneous and non-specific, similar to those in other liver diseases, but liver immunopathological features showed positive intense deposits of complement lq in 7/10 patients with lupus hepatitis and negative complement lq deposits in all patients with other liver diseases （Fisher＇s exact test, P=-0.011）. Conclusions Lupus hepatitis was not infrequent in active SLE patients which would be one of the indices indicating SLE activity. Positive intense deposit of complement lq in liver may be a characteristic immunopathological feature of lupus hepatitis, which provides a new way to differentially dia qnose lupus hepatitis from other liver diseases.
文摘目的探讨白芍总苷片与糖皮质激素联合治疗系统性红斑狼疮肝损害的临床疗效,为提高该病治疗效果提供参考.方法收集医院2013-06/2015-06 92例系统性红斑狼疮肝损害患者作为研究对象,依据随机对照组表法分为联合组与对照组,各46例.对照组给予常规糖皮质激素治疗,联合组给予白芍总苷片与糖皮质激素联合治疗,观察两组患者治疗总有效率、肝功能改善状况以及不良反应.结果联合组总有效率高于对照组(93.5%v s73.9%),差异有统计学意义(P<0.05).治疗后联合组ALT、γ-GT、AST均明显的低于对照组,(31.7±7.4 vs 62.4±10.5)、(21.7±4.8 vs35.7±5.8)、(88.4±9.1 vs 121.6±10.7),组间差异有统计学意义(P<0.05).联合组治疗不良反应发生率明显的低于对照组(8.7%vs23.9%),差异有统计学意义(P<0.05).结论系统性红斑狼疮肝损害患者在常规糖皮质激素治疗上加用白芍总苷片治疗效果明显,显著改善患者肝功能,且不良反应少,安全性高,值得应用推广.
