[1]刘维高,金生.新型冠状病毒肺炎患者转氨酶水平的Meta分析[J].第三军医大学学报,2020,42(14):1476-1483.
 LIU Weigao,JIN Sheng.Levels of alanine aminotransferase and aspartate aminotransferase in coronavirus disease 2019 patients: a meta-analysis[J].J Third Mil Med Univ,2020,42(14):1476-1483.
点击复制

新型冠状病毒肺炎患者转氨酶水平的Meta分析(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第14期
页码:
1476-1483
栏目:
特别报道
出版日期:
2020-07-30

文章信息/Info

Title:
Levels of alanine aminotransferase and aspartate aminotransferase in coronavirus disease 2019 patients: a meta-analysis
作者:
刘维高1金生
内江市中医医院ICU;重庆医科大学附属第二医院感染与肝病中心
Author(s):
LIU Weigao1 JIN Sheng

ICU, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, Sichuan Province, 641100; 2Center for Infection and liver Disease, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
 

关键词:
新型冠状病毒肺炎肝功能丙氨酸转氨酶天冬氨酸转氨酶Meta分析
Keywords:
coronavirus disease 2019 liver function alanine aminotransferase aspartate aminotransferase meta-analysis
分类号:
R181.23; R446.112; R563.
文献标志码:
A
摘要:

目的评价新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)患者转氨酶[丙氨酸转氨酶(alanine aminotransferase, ALT)和天冬氨酸转氨酶(aspartate aminotransferase, AST)]水平。方法检索PubMed、MedRxiv and bioRxiv、万方期刊数据库、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库、中华医学期刊网等, 搜集以COVID-19为主题的相关研究。检索时限均为建库至2020年4月10日。由两名评价员独立筛选文献、提取资料,采用RevMan 5.3 软件进行Meta分析。结果共18项研究、2 405例患者纳入分析,其中非重型组1 898例,重型组507例。与非重型组比较,重型组发生转氨酶异常/肝损伤的比率显著高于非重型组患者,差异有统计学意义(OR=0.35,95% CI为0.27~0.46,Z=7.78, P<0.000 01;RR=0.53,95%CI为0.46~0.61,Z=8.60,P<0.000 01);两组间转氨酶水平差异也具有统计学意义(ALT:MD=-0.63 U/L,95%CI为-1.26~-0.01,Z=2.00,P=0.05;AST:MD=-0.81 U/L, 95%CI为-1.45~-0.16,Z=2.46,P=0.01)。结论COVID-19可合并肝损伤,重型患者转氨酶异常/肝损伤比率较非重型患者高,重型患者转氨酶水平异常更明显。

Abstract:

ObjectiveTo evaluate the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in coronavirus disease 2019 (COVID-19) patients. MethodsPubMed, MedRxiv and bioRxiv, WangFang Data, CNKI, VIP, and Chinese Medical Journal Network databases were searched to collect researches for COVID-19 up to April 10, 2020. RevMan 5.3 software was used for meta-analysis. Two evaluators independently screened the literature, extracted the data, and evaluated the risk of bias of relevant studies. ResultsThere were 18 studies included. Among the 2 405 patients, 1 898 of them suffered from not severe COVID-19 (non-severe group), and the rest 507 patients from severe COVID-19 (severe group). The severe group had significantly higher proportion of transaminase abnormality/liver injury when compared with the non-severe group (OR=0.35, 95%CI: 0.27~0.46, Z=7.78, P<0.000 01; RR=0.53, 95%CI: 0.46~0.61, Z=8.60, P<0.000 01). Obvious differences were seen in the transferase levels between the 2 groups (ALT: MD=-0.63 U/L, 95%CI: -1.26~-0.01, Z=2.00, P=0.05; AST: MD=-0.81 U/L, 95%CI: -1.45~-0.16, Z=2.46, P=0.01). ConclusionCOVID-19 maybe accompanied with liver injury. There are a larger proportion of patients with transaminase abnormality/liver injury in the severe COVID-19 patients, especially in the abnormality.
 

参考文献/References:

[1]李力, 李琦, 程金波, 等. 新型冠状病毒肺炎患者分层治疗与中医辅助治疗方案[J]. 第三军医大学学报, 2020, 42(4): 427-430. DOI: 10.16016/j.1000-5404. 20200204.

LI L, LI Q, CHENG J B, et al.Stratified therapy and adjuvant therapy with Chinese medicine for pneumonia patients with novel coronavirus infection[J]. J Third Mil Med Univ, 2020, 42(4): 427-430. DOI: 10.16016/j.1000- 5404.20200204.

[2]陈敏, 安薇, 夏飞, 等. COVID-19不同临床分型患者病例资料回顾性分析[J]. 医药导报, 2020, 39(4): 459-464. DOI: 10.3870/j.issn.1004-0781. 2020.04.007.

CHEN M, AN W, XIA F, et al. Retrospective analysis of COVID-19 patients with different clinical subtypes[J]. Her Med, 2020, 39(4): 459-464. DOI: 10.3870/j.issn.1004-0781.2020.04.007.

[3]房晓伟, 梅清, 杨田军, 等. 2019新型冠状病毒感染的肺炎79例临床特征及治疗分析[J]. 中国药理学通报, 2020, 36(4): 453-459. DOI: 10.3969/j.issn.1001-1978.2020.

FANG X W, MEI Q, YANG T J, et al. Clinical characteristics and treatment strategies of 79 patients with COVID-19[J]. Chin Pharmacol Bull, 2020, 36(4): 453-459. DOI: 10.3969/j.issn.1001-1978.2020.

[4]HUANG C L, WANG Y M, LI X W, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223): 497-506. DOI:10.1016/S0140-6736(20)30183-5.

[5]HUANG H, CAI S J, LI Y P, et al. Prognostic factors for COVID-1 19 pneumonia progression to severe symptom based on the earlier clinical features: a retrospective analysis[J]. medRxiv, 2020. DOI: 10.1101/2020. 03.28.20045989.

[6]李翠芝, 李美瑜, 甘露, 等. 新型冠状病毒肺炎患者合并心脏和肝脏损害的临床分析[J]. 广东医学, 2020, 41(9): 874-877. DOI:10.13820/j.cnki.gdyx.20200814.

LI C Z, LI M Y, GAN L, et al.Heart and liver damage in coronavirus disease-2019[J].Guangdong Med J, 2020, 41(9): 874-877. DOI: 10.13820/j.cnki.gdyx.20200814.

[7]刘川, 江自成, 邵初晓, 等.  新型冠状病毒肺炎与肝功能损伤的关系初探:一项多中心研究 [J]. 中华肝脏病杂志, 2020, 28(2): 107-111. DOI: 10.3760/cma.j.issn.1007-3418.2020.02.002.

LIU C, JIANG Z C, SHAO C X, et al. Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study[J]. Chin J Hepatol, 2020, 28(2): 107-111. DOI: 10.3760/cma.j.issn.1007-3418.2020.02.002.

[8]LIU W, TAO Z W, WANG L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease [J]. Chin Med J, 2020, 133(9):1032-1038. DOI: 10.1097/CM9.0000000000000775.

[9]彭昱东, 孟凯, 官红权, 等.  心血管病患者感染新型冠状病毒肺炎112例临床特点及转归 [J/OL]. 中华心血管病杂志, 2020, 48. (2020-03-02).  http://rs.yiigle.com/yufabiao/1183314.htm. DOI: 10.3760/cma.j.cn112148-20200220-00105.

PENG Y D, MENG K, GUAN H Q, et al. Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV[J/OL]. Chin J Cardiol, 2020, 48. (2020-03-02). http://rs.yiigle.com/yufabiao/1183314.htm. DOI: 10.3760/cma.j.cn112148- 20200220-00105.

[10]方丹, 马敬东, 官佳轮, 等.  武汉地区新型冠状病毒肺炎住院患者消化系统表现的单中心描述性研究 [J]. 中华消化杂志, 2020, 40 (3): 151-156. DOI: 10.3760/cma.j.issn.0254-1432. 2020.03.003.

FANG D, MA J D, GUAN J L, et al. Manifestations of digestive system in hospitalized patients with novel coronavirus pneumonia in Wuhan, China: a single-center, descriptive study[J]. Chin J Dig, 2020, 40 (3): 151-156. DOI: 10.3760/cma.j.issn. 0254-1432.2020.03.003.

[11]高文, 杨雪, 郑小勤, 等. 北京地区90例新型冠状病毒肺炎患者临床特征分析[J]. 解放军医学院学报, 2020, 4(3): 208-211. DOI: 10.3969/j.issn.2095-5227.2020.03.002.

GAO W, YANG X, ZHENG X Q, et al. Clinical characteristic of 90 patients with COVID-19 hospitalized in a Grade-A hospital in Beijing[J]. Acad J Chin PLA Med Sch, 2020, 4(3): 208-211. DOI: 10.3969/j.issn.2095-5227.2020.03.002.

[12]李丹,龙云铸,黄彭,等. 株洲地区80例新型冠状病毒肺炎患者临床特征分析[J]. 中国感染控制杂志, 2020, 19(3): 227-233. DOI: 10.12138/j.issn.1671-9638.20206514.

LI D, LONG Y Z, HUANG P, et al. Clinical characteristics of 80 patients with COVID-19 in Zhuzhou City[J]. Chin J Infect Control, 2020, 19(3): 227-233. DOI: 10.12138/j.issn.1671- 9638.20206514.

[13]李丹, 刘洪艳, 王妍, 等. 新型冠状病毒肺炎30例临床特征分析[J/OL]. 中华传染病杂志, 2020, 38. (2020-03-05).http://rs.yiigle.com/yufabiao/1183767.htm. DOI: 10.3760/cma.j.cn311365-20200218-00076.

LI D, LIU H Y, WANG Y, et al. Clinical features of 30 cases with novel coronavirus pneumonia[J/OL]. Chin J Infect Dis, 2020, 38.(2020-03-05).http://rs.yiigle.com/yufabiao/1183767.htm. DOI: 10.3760/cma.j.cn311365-20200218-00076.

[14]刘敏, 贺鹏, 刘辉国, 等.  30例医务人员新型冠状病毒肺炎的临床特征分析[J]. 中华结核和呼吸杂志, 2020, 43 (3): 209-214. DOI: 10.3760/cma.j.issn.1001-0939.2020.03.014.

LIU M, HE P, LIU H G, et al. Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia[J]. Chin J Tuberc Respir Dis, 2020, 43 (3): 209-214. DOI: 10.3760/cma.j.issn.1001-0939.2020.03.014.

[15]向天新, 刘家明, 许飞, 等. 江西地区49例新型冠状病毒肺炎患者临床特征分析[J]. 中国呼吸与危重监护杂志, 2020, 19(2): 154-160. DOI:10.7507/1671-6205.202002070.

XIANG T X, LIU J M, XU F, et al. Analysis of clinical characteristics of 49 patients with coronavirus disease 2019 in Jiangxi[J]. Chin J Respir Crit Care Med, 2020, 19(2): 154-160. DOI:10.7507/1671-6205.202002070.

[16]熊娟, 江万里, 周倩, 等. 新型冠状病毒肺炎89例临床特征、治疗及预后分析[J/OL]. 武汉大学学报(医学版),2020: 1-5. DOI: 10.14188/j.1671- 8852.2020.0103.

XIONG J, JIANG W L, ZHOU Q, et al. Clinical characteristics, treatment, and prognosis in 89 cases of COVID-19[J/OL]. Med J Wuhan Univ,2020:1-5. DOI: 10.14188/j.1671-8852.2020.0103.

[17]张维, 侯维, 李侗曾, 等. 74例新型冠状病毒肺炎临床特征分析[J]. 首都医科大学学报, 2020, 41(2): 161-167. DOI: 10.3969/j.issn.1006-7795. 2020.02.003.

ZHANG W, HOU W, LI T Z, et al. Clinical characteristics of 74 hospitalized patients with COVID-19[J]. J Cap Med Univ, 2020, 41(2): 161-167. DOI: 10.3969/j.issn.1006-7795. 2020.02.003.

[18]汪姝惠, 韩平, 肖芳, 等. 新型冠状病毒肺炎住院患者 333 例的肝损伤表现[J]. 中华消化杂志 , 2020, 40(3): 157-161. DOI:10.3760/cma.j.issn. 0254 -1432.2020.03.004.

WANG S H, HAN P, XIAO F, et al. Manifestation of liver injury in 333 hospitalized patients with coronavirus disease 2019[J]. Chin J Dig,  2020, 40(3): 157-161. DOI:10.3760/cma.j.issn.0254 -1432.2020.03.004.


[19]GUAN W J, NI Z Y, HU Y, et al. Clinical characteristics of 2019 novel coronavirus infection in China[J]. medRxiv, 2020. DOI: 10.1101/2020.02.06. 20020974.

[20]CHAI X, HU L, ZHANG Y, et al. Specific ACE2 expression incholangiocytes may cause liver damage after 2019-ncov infection[J]. bioRxiv, 2020. DOI: 10.1101/2020.02.03.931766.

[21]HOFFMANN M, KLEINE-WEBER H, KRGER N, et al. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells[J]. bioRxiv, 2020. DOI: 10.1101/2020.01.31. 929042.

[22]中国疾病预防控制中心新型冠状病毒肺炎应急响应机制流行病学组. 新型冠状病毒肺炎流行病学特征分析[J]. 中华流行病学杂志, 2020, 41 (2): 145-151. DOI: 10.3760/cma.j.issn.0254-6450. 2020.02.003.

The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China[J]. Chin J Epidemiol, 2020, 41 (2): 145-151. DOI: 10.3760/cma.j.issn.0254-6450.2020.02.

[23]ZHU N, ZHANG D Y, WANG W L, et al. A novel coronavirus from patients with pneumonia in China, 2019[J]. N Engl J Med, 2020, 382(8): 727-733. DOI:10.1056/nejmoa2001017.

[24]WANG D W, HU B, HU C , et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China[J]. JAMA, 2020, 323(11): 1061-1069. DOI: 10.1001/jama.2020.1585.

[25]XU Z, SHI L, WANG Y J, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome[J]. Lancet Respir Med, 2020, 8(4): 420-422. DOI:10.1016/S2213- 2600(20)30076-X.

[26]关贵文, 高林, 王建文, 等. 新型冠状病毒感染肺炎患者肝酶异常的机制探究[J]. 中华肝脏病杂志, 2020, 28(2): 100-106. DOI:10.3760/cma.j.issn.1007-3418.2020.02.002.

GUAN G W, GAO L, WANG J W, et al. Exploring the mechanism of liver enzyme abnormalities in patients with novel coronavirus-infected pneumonia[J]. Chin J Hepatol, 2020, 28(2): 100-106. DOI: 10.3760/cma.j.issn.1007-3418. 2020.02.002.

相似文献/References:

[1]吴丽娟,陈伟,蔡晋,等.血清HBV-DNA快速适时荧光定量分析的临床应用评价[J].第三军医大学学报,2006,28(19):1988.
[2]冯正平,王富华.甲状腺机能亢进症患者肝功能改变及影响因素的初探[J].第三军医大学学报,2005,27(03):212.
[3]李蓉,冷言冰,艾国平,等.长期摄入低剂量贫铀对大鼠血象与肝肾功能的影响[J].第三军医大学学报,2007,29(17):1643.
 LI Rong,LENG Yan-bing,AI Guo-ping,et al.Changes of hematologic and urinary parameters and functions of liver and kidney after chronic oral exposure to lowdose depleted uranium[J].J Third Mil Med Univ,2007,29(14):1643.
[4]贾立峰,张连阳,李勇.失血性休克复苏后CO2气腹对兔肝功能及肝血流量的影响[J].第三军医大学学报,2009,31(11):1021.
 JIA Li-feng,ZHANG Lian-yang,LI Yong.Effects of CO2 pneumoperitoneum on hepatic function and hepatic blood flow after hemorrhagic shock resuscitation in rabbits[J].J Third Mil Med Univ,2009,31(14):1021.
[5]杨京,戚华兵,赵玲,等.脓毒症模型大鼠循环内皮细胞与肝功能状态间关系的相关性研究[J].第三军医大学学报,2007,29(12):1171.
 YANG Jing,QI Hua-bing,ZHAO Ling,et al.Correlation between circulating endothelial cell and hepatic functional status in rat model of sepsis[J].J Third Mil Med Univ,2007,29(14):1171.
[6]夏锋,董家鸿,何振平,等.去交感神经状态对大鼠肝功能的影响[J].第三军医大学学报,2004,26(03):0.[doi:10.16016/j.1000-5404.2004.03.017 ]
 XIA Feng,DONG Jia hong,HE Zhen ping,et al.[J].J Third Mil Med Univ,2004,26(14):0.[doi:10.16016/j.1000-5404.2004.03.017 ]
[7]陈莉,韩本立.72例肝脏手术病人血清OCT和m-GOT活性的变化及其临床意义[J].第三军医大学学报,2000,22(09):0.[doi:10.16016/j.1000-5404.2000.09.036 ]
 CHEN Li,HAN Ben li.[J].J Third Mil Med Univ,2000,22(14):0.[doi:10.16016/j.1000-5404.2000.09.036 ]
[8]王威巍,张宇,尤楠,等.粪便细菌移植对肝性脑病大鼠肝功能及血氨的影响[J].第三军医大学学报,2017,39(13):1321.
 WANG Weiwei,ZHANG Yu,YOU Nan,et al.Effects of fecal microbiota transplantation on liver function and blood ammonia in hepatic encephalopathy rats[J].J Third Mil Med Univ,2017,39(14):1321.
[9]查盈盈,葛进,郑超,等.纳米材料富勒醇对铅中毒大鼠肝肾功能损伤及血液学异常表现的修复作用[J].第三军医大学学报,2018,40(21):1962.
 ZHA Yingying,GE Jin,ZHENG Chao,et al.Nanomaterial fullerenol attenuates liver and kidney impairments and hematological abnormalities in leadpoisoned rats[J].J Third Mil Med Univ,2018,40(14):1962.
[10]张宇,王威巍,左国华,等.粪便细菌移植对非酒精性脂肪性肝病大鼠肝功能和脂代谢紊乱的影响[J].第三军医大学学报,2019,41(13):1200.
 ZHANG Yu,WANG Weiwei,ZUO Guohua,et al.Effects of fecal microbiota transplantation on liver function and lipid metabolism disorder in rats with nonalcoholic fatty liver disease[J].J Third Mil Med Univ,2019,41(14):1200.

更新日期/Last Update: 2020-07-23