新冠肺炎患者肝肾功能损害的临床特征及其与重症及死亡的相关性分析

高梦圆; 赵泳冰; 刘玺; 胡长江; 白秀梅; 陈慧; 刘春雨; 吕金莎; 黄进源; 刘永军; 杨仕明; 何佳霖; 周圆圆

doi:10.16016/j.1000-5404.202105042

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新冠肺炎患者肝肾功能损害的临床特征及其与重症及死亡的相关性分析

临床医学 | 更新时间：2026-01-09

- 新冠肺炎患者肝肾功能损害的临床特征及其与重症及死亡的相关性分析
- Clinical characteristics of liver and kidney injuries and correlation with severity and mortality in patients with COVID-19
- 第三军医大学学报 2021年43卷第20期页码：2241-2249
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院消化内科
  2.430000 武汉，泰康同济医院
  3.430000 武汉，金银潭医院
  4.430000 武汉，火神山医院
- 作者简介：
  
  [ 周圆圆，E-mail：42587363@qq.com ZHOU Yuanyuan,E-mail: 42587363@qq.com
- 基金信息：
  
  重庆市科卫联合项目(2020FYYX123)
- DOI：10.16016/j.1000-5404.202105042
  中图分类号： R195.4;R446.112;R512.99
- 收稿：2021-05-11，
  
  修回：2021-07-04，
  
  纸质出版：2021-10-30
- 稿件说明：
移动端阅览
高梦圆, 赵泳冰, 刘玺, 等. 新冠肺炎患者肝肾功能损害的临床特征及其与重症及死亡的相关性分析[J]. 第三军医大学学报, 2021,43(20):2241-2249.

Mengyuan GAO, Yongbing ZZHAO, Xi LIU, et al. Clinical characteristics of liver and kidney injuries and correlation with severity and mortality in patients with COVID-19[J]. Journal of Third Military Medical University, 2021, 43(20): 2241-2249.
高梦圆, 赵泳冰, 刘玺, 等. 新冠肺炎患者肝肾功能损害的临床特征及其与重症及死亡的相关性分析[J]. 第三军医大学学报, 2021,43(20):2241-2249. DOI： 10.16016/j.1000-5404.202105042.

Mengyuan GAO, Yongbing ZZHAO, Xi LIU, et al. Clinical characteristics of liver and kidney injuries and correlation with severity and mortality in patients with COVID-19[J]. Journal of Third Military Medical University, 2021, 43(20): 2241-2249. DOI： 10.16016/j.1000-5404.202105042.

摘要

目的

描述新型冠状病毒肺炎(COVID-19)患者肝肾功能损害的临床特征及其对重症化和病死率的影响。

方法

以2020年2月4日至2020年4月16日在火神山医院、金银潭医院、泰康同济医院确诊，且无肝肾基础疾病的3 548例COVID-19患者为分析对象，通过病历提取患者一般资料、临床特征、实验室结果及死亡等信息，采用SPSS 23.0进行数据描述和分析。

结果

3548例COVID-19患者纳入研究，重症及以上病例875例(24.7%)，死亡91例(2.6%)；丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和肌酐(Cr)升高比例分别为14.6%(513/3 548)、3.4%(119/3 548)、2.8%(101/3 548)；与ALT、AST、Cr正常的COVID-19患者相比，ALT升高的患者发生重症化和死亡的风险均未显著增加，AST、Cr升高的患者发生重症和死亡的风险均显著升高(

0.05)；肝或肾功能损伤者和肝肾功能均损伤者发生重症的风险分别是肝肾功能正常者的2.32倍(95%

: 1.73-3.10)和11.40倍(95%

: 2.36-54.98)，发生死亡的风险分别是肝肾功能正常者的5.21倍(95%

: 3.10-8.75)和13.53倍(95%

：2.76-66.32)；采用Logistic回归筛选出重症及死亡的独立相关因素作为校正因素后发现，肝或肾功能损伤的人群重症及死亡发生的风险分别是肝肾功能正常人群的1.612倍(95%

: 1.168-2.224)、2.907倍(95%

: 1.612-5.242)。

结论

COVID-19患者若出现肝功能损害和肾功能损害，其重症化倾向和死亡风险明显升高，应进行早期干预。

Abstract

Objective

To describe the clinical characteristics of liver and kidney injuries and investigate its effect on the severity and mortality in the COVID-19 patients.

Methods

A total of 3 548 patients diagnosed with COVID-19 but without liver and kidney diseases admitted in the Huoshenshan Hospital

Jinyintan Hospital and Taikang Tongji Hospital from February 4

2020 to April 16

2020 were recruited in this study. Their clinical data were extracted from medical database

including general information

clinical features

laboratory results and outcomes such as death were collected and analyzed. SPSS statistics 23.0 was used to perform the statistical description and analysis.

Results

Among the 3 548 patients with COVID-19

875 (24.7%) cases were severe illness and above and 91 (2.6%) died during hospitalization. The proportions of the patients with higher alanine amiotransferase (ALT)

aspartate aminotransferase (AST) and creatinine (Cr) were 14.6% (513/3 548)

3.4% (119/3 548) and 2.8% (101/3 548)

respectively. Compared with the patients with normal ALT

AST and Cr

the patients with elevated ALT did not have a significantly increased risk of severe illness or death (

0.05)

and the risk of severe illness and death was significantly increased in those with elevated AST and Cr (

0.05). The risk of severe disease was 2.32 times (95%

: 1.73-3.10) and 11.40 times (95% CI: 2.36-54.98) for those with single or both liver and kidney injuries

and the risk of death was 5.21 times (95%

: 3.10-8.75) and 13.53 times (95%

: 2.76-66.32) for those with normal liver and kidney function

respectively. Logistic regression analysis indicated that after inde

pendent factors related to severe illness and death screened out as correction factors

the risk of severe illness and death was 1.612 times (95%

: 1.17-2.22) and 2.907 times (95%

: 1.61-5.24) of patients with liver or kidney injuries when compared with those with normal function

respectively.

Conclusion

The COVID-19 patients with liver and renal injuries have a significantly increased tendency to become severity and mortality

and should undergo early intervention.

关键词

Keywords

references

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