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在COVID-19新流行病发生期间肝损伤

Nizama Salihefendic¹, Muharem Zildzic¹, Izet Masic²

¹Private Medical Practice "Medicus A", Gracanica, Bosnia and Herzegovina.

Materia socio-medica

|February 2, 2026

概括

这份病例报告强调,即使是轻度的COVID-19也可能导致急性肝损伤,特别是在患有潜在的代谢功能障碍相关脂肪性肝病 (MASLD) 的患者中. 观察到一种明显的模式,即肝酶和费里丁的升高与正常胆红素.

科学领域:

肝病学肝病学是一种肝病学.
传染性疾病传染性疾病
病毒学病毒学

背景情况:

严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 主要影响呼吸系统,但可以影响包括肝脏在内的多个器官.
在住院COVID-19患者中,肝细胞损伤很常见,但在稳定,年轻人中,明显的肝损伤很少见.
肝损伤的潜在机制包括直接的病毒影响,免疫反应,全身炎症和代谢压力.

研究的目的:

报告三个成年人感染SARS-CoV-2的病例,有轻微的呼吸道症状,患有急性肝损伤.
在没有其他原因的情况下,调查SARS-CoV-2相关的肝损伤的临床表现和生物化学概况.

主要方法:

在COVID-19浪潮期间的一项有针对性的门诊研究包括针对疑似病例的常规肝脏检测.
实验室评估包括肝酶,肝炎血清学,自身免疫标志物和炎症参数.
图像 (超声波或MRI) 用于排除肝脏结构病理.
追溯分析确定了受影响患者的代谢功能障碍相关的底层脂肪性肝病 (MASLD).

主要成果:

三名先前健康的男性 (25-45岁) 经证实感染SARS-CoV-2,呈现急性肝损伤.
患者经历了轻微的症状 (疲劳,肌痛),没有呼吸困难.
观察到AST,ALT,GGT,费里丁和D-二次体的显著升高,胆红素水平正常.
一个不成比例地升高的转氨基酶和GGT与保存的胆红素的一致的生化模式表明了与SARS-CoV-2相关的肝细胞损伤.
代谢功能障碍相关的底层脂肪性肝病 (MASLD) 在所有三名患者中都被追溯确定.

结论:

临床稳定的COVID-19患者,特别是患有MASLD的患者,可以经历急性肝细胞损伤.
一种独特的SARS-CoV-2肝损伤表型的特点是AST,ALT,GGT和费里丁显著升高,胆红素正常.
建议对所有COVID-19患者进行例行肝功能监测,无论呼吸道症状严重程度如何,特别是那些有代谢风险因素的人.

关键词:

在 COVID-19 疫情中,GGT GGT 的意思是什么?马斯尔德马斯尔德是什么意思氨基转移酶的使用家庭医学的家庭医学.肝脏损伤肝脏损伤是什么?

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