新型冠状病毒肺炎对肾功能影响的评价

G. Arslan
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Categorical data were described as continuous data as median with interquartile range (IQR) and percentages (%). Results: In total, 30 patients (25.0%) required mechanical ventilation, Overall, 39.1% (47) developed acute kidney injury during hospitalization, out of which 10.8% reached stage 1, 15.0% reached stage 2, and 13.3% reached stage 3. Dialytic support was required for seven (17.1% of all patients). COVID-19 pneumonia patients had higher levels of aspartate aminotransferase (AST) (55.02±58.04), alanine aminotransferase (ALT) (74.07±140.94), lactate dehydrogenase (LDH) (483.48±477.51), C-reactive protein (CRP) (88.02±72.17), D-dimer (1023±1548.01), procalcitonin (3.70± 6.52). In addition, a proportion of COVID-19 pneumonia patients but no non-COVID-19 pneumonia patients had abnormally increased AST (10.0-274.0), ALT (7.0-854.0), LDH (164-3547), CRP (5.10- 310.90), D-dimer (151-6212), procalcitonin (195-433). SpO2 of COVID-19 pneumonia patients had 78-97%, patients who need dialysis treatment due to pneumonia, follow-up coagulation profile (Procalcitonin, LDH, D-dimer), liver-renal function (ALT, AST, Creatine, Urea, Albumin), assessing signs of DVT and psychological support. 89 patients (74.2%) received corticosteroid, 73 patients (60.8%) received expectorant, 61 patients (50.8%) received vitamin C or B complex, 110 patients (91.7%) received anticoagulant and 73 patients (60.8%) received antibiotics. All of the COVID-19 pneumonia patients received the antiviral drug. Conclusion: As the disease progresses, differences in laboratory results and radiological findings may indicate that some complications have developed. COVID-19 pneumonia draws attention with liver function tests such as AST / ALT, LDH, infection markers in the blood, and the high rate of coagulation factors such as PCT and D-dimer during the hospital stay. 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Dialytic support was required for seven (17.1% of all patients). COVID-19 pneumonia patients had higher levels of aspartate aminotransferase (AST) (55.02±58.04), alanine aminotransferase (ALT) (74.07±140.94), lactate dehydrogenase (LDH) (483.48±477.51), C-reactive protein (CRP) (88.02±72.17), D-dimer (1023±1548.01), procalcitonin (3.70± 6.52). In addition, a proportion of COVID-19 pneumonia patients but no non-COVID-19 pneumonia patients had abnormally increased AST (10.0-274.0), ALT (7.0-854.0), LDH (164-3547), CRP (5.10- 310.90), D-dimer (151-6212), procalcitonin (195-433). 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引用次数: 0

摘要

背景:COVID-19导致死亡的病例可能发生严重急性呼吸道感染、肺炎、肾衰竭和多器官衰竭。强调在COVID-19肺炎病例中应提高医护人员对肾功能的认识。通过护士对肾功能变化的控制,可以采取快速有效的措施治疗COVID-19肺炎。方法:回顾性评价在大流行医院就诊的新冠肺炎确诊患者的肾功能。对2020年5月1日至11月30日期间输入的120例COVID-19肺炎患者的医院和护士观察档案进行了检查。分类数据用四分位数范围(IQR)和百分比(%)的中位数描述为连续数据。结果:共30例(25.0%)患者需要机械通气,住院期间发生急性肾损伤的患者占39.1%(47例),其中达到1期的占10.8%,达到2期的占15.0%,达到3期的占13.3%。7例(占所有患者的17.1%)需要透析支持。COVID-19肺炎患者的天冬氨酸转氨酶(AST)(55.02±58.04)、丙氨酸转氨酶(ALT)(74.07±140.94)、乳酸脱氢酶(LDH)(483.48±477.51)、c反应蛋白(CRP)(88.02±72.17)、d -二聚体(1023±1548.01)、降钙素原(3.70±6.52)水平较高。此外,部分COVID-19肺炎患者而非COVID-19肺炎患者存在AST(10.0-274.0)、ALT(7.0-854.0)、LDH(164-3547)、CRP(5.10- 310.90)、d -二聚体(151-6212)、降钙素原(195-433)异常升高。COVID-19肺炎患者SpO2为78-97%,因肺炎需要透析治疗的患者,随访凝血情况(降钙素原、LDH、d -二聚体),肝肾功能(ALT、AST、肌酸、尿素、白蛋白),评估DVT体征及心理支持。使用皮质类固醇89例(74.2%),使用祛痰药73例(60.8%),使用维生素C或B复合物61例(50.8%),使用抗凝剂110例(91.7%),使用抗生素73例(60.8%)。所有COVID-19肺炎患者均接受抗病毒药物治疗。结论:随着病情的发展,实验室检查结果和影像学表现的差异可能提示出现了一些并发症。COVID-19肺炎引起关注的是肝功能检查,如AST / ALT、LDH、血液感染标志物,以及住院期间PCT、d -二聚体等凝血因子的高发。这些升高的数值可能导致肾脏坏死的事实也带来了真相。仔细监测因COVID-19引起的肺炎患者的AST / ALT、LDH、PCT和d -二聚体升高等实验室检查结果,可能为肾脏损害提供早期行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the Effect of COVID-19 Pneumonia on Kidney Function
Background: Severe acute respiratory tract infection, pneumonia, kidney failure, and multi-organ failure may develop in cases that result in death due to COVID-19. It is emphasized that the awareness of healthcare professionals about kidney functions should be increased in cases of COVID-19 pneumonia. Quick and effective steps can be taken in the treatment of COVID-19 pneumonia with the controlling approach of nurses to changes in kidney functions. Method: This study was carried out retrospectively to evaluate the kidney functions of patients diagnosed with COVID-19 pneumonia who were hospitalized in the pandemic hospital. Hospital and nurse observation files of 120 patients who were introduced to COVID-19 pneumonia between 1 May and 30 November 2020 were examined. Categorical data were described as continuous data as median with interquartile range (IQR) and percentages (%). Results: In total, 30 patients (25.0%) required mechanical ventilation, Overall, 39.1% (47) developed acute kidney injury during hospitalization, out of which 10.8% reached stage 1, 15.0% reached stage 2, and 13.3% reached stage 3. Dialytic support was required for seven (17.1% of all patients). COVID-19 pneumonia patients had higher levels of aspartate aminotransferase (AST) (55.02±58.04), alanine aminotransferase (ALT) (74.07±140.94), lactate dehydrogenase (LDH) (483.48±477.51), C-reactive protein (CRP) (88.02±72.17), D-dimer (1023±1548.01), procalcitonin (3.70± 6.52). In addition, a proportion of COVID-19 pneumonia patients but no non-COVID-19 pneumonia patients had abnormally increased AST (10.0-274.0), ALT (7.0-854.0), LDH (164-3547), CRP (5.10- 310.90), D-dimer (151-6212), procalcitonin (195-433). SpO2 of COVID-19 pneumonia patients had 78-97%, patients who need dialysis treatment due to pneumonia, follow-up coagulation profile (Procalcitonin, LDH, D-dimer), liver-renal function (ALT, AST, Creatine, Urea, Albumin), assessing signs of DVT and psychological support. 89 patients (74.2%) received corticosteroid, 73 patients (60.8%) received expectorant, 61 patients (50.8%) received vitamin C or B complex, 110 patients (91.7%) received anticoagulant and 73 patients (60.8%) received antibiotics. All of the COVID-19 pneumonia patients received the antiviral drug. Conclusion: As the disease progresses, differences in laboratory results and radiological findings may indicate that some complications have developed. COVID-19 pneumonia draws attention with liver function tests such as AST / ALT, LDH, infection markers in the blood, and the high rate of coagulation factors such as PCT and D-dimer during the hospital stay. The fact that these elevated values ​​may cause necrosis in the kidneys also brings about the truth. Careful monitoring of laboratory findings such as elevation of AST / ALT, LDH, PCT, and D-dimer in patients who develop pneumonia due to COVID-19 may provide early action for kidney damage.
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