112例新型冠状病毒肺炎患者肝肾功能和心肌酶学变化分析

目的 观察新型冠状病毒肺炎(COVID-19)患者血清肝肾功能和心肌酶学的变化。方法 在本组112例COVID-19肺炎患者中,普通型68例,重型22例,危重型22例。常规检测血清肝肾功能指标及肌钙蛋白T(cTnT)、肌红蛋白(Myo)和肌酸激酶同工酶(CK-MB)。结果 各组COVID-19肺炎患者血清肾功能指标变化不明显,差异无统计学意义(P>0.05);危重组患者血清ALT和AST升高发生率分别为31.8%和45.5%,显著高于重型组(分别为4.6%和13.6%,P<0.05)或普通型组(0.0%和2.9%,P<0.05);危重组血清cTnT、Myo和CK-MB升高发生率分别为72.7%、45.5%和27.3%,显著高于重型组(分别为22.7%、16.6%和9.1%,P<0.05)或普通型组(分别为4.4%、1.5%和1.5%,P<0.05);24例心肌酶学异常患者病死率为25%,显著高于88例心肌酶学正常组的1.1%(P<0.05)。结论 单中心回顾性分析显示血清心肌酶学异常的新型冠状病毒肺炎患者病情可能比较危重,病死率比较高,需格外加强干预。

Serum liver and kidney function tests and myocardial enzymes in 112 patients with coronavirus-19 pneumonia

Objective The aim of this study was to analyze the changes of serum liver and kidney function tests and cardiac muscle enzymes in patients with coronavirus-19(covid-19)pneumonia.Methods The clinical materials in 112 patients with covid-19 pneumonia were retrospectively analyzed and it included typical type in 68,severe type in 22 and critical type in 22.Serum liver and kidney function tests and myocardial enzyme cardiac troponin Test(cTnT),myohemoglobin(Myo)and creatine kinase Isoenzyme-MB(CK-MB)levels were determined routinely.Results There was no significant difference as respect to serum renal function tests in the three groups(P>0.05);the abnormal incidences of serum ALT and AST in critical patients were 31.8%and 45.5%,much higher than 4.6%and 13.6%(P<0.05)in severe ones or 0.0%and 2.9%(P<0.05)in patients with typical ones;the abnormal elevated incidences of serum cTnT,Myo and CK-MB in critical patients were 72.7%,45.5%and 27.3%,significantly higher than 22.7%,16.6%and 9.1%,respectively(P<0.05)in severe patients or 4.4%,1.5%and 1.5%,respectively(P<0.05)in typical patients;out of 24 patients with abnormal serum myocardial enzyme,the fatality rate was 25%,much higher than 1.1%(P<0.05)in 88 patients with normal serum myocardial enzyme.Conclusion The results from a single-centered retrospective study suggest that the patients with covid-19 pneumonia could have serum myocardial enzyme elevation,which might hint the critical clinical type and poor prognosis.