浅析新冠肺炎肝损伤的发病机制

Analysis of the Pathogenesis of Liver Injury Caused by COVID-19

摘要: 2019冠状病毒病(Coronavirus Disease 2019, COVID-19)引起肝脏损伤在临床中并不少见。目前认为新冠肺炎发生肝损伤的原因与病毒、炎症、药物、低氧等密切相关。本文通讯作者通过观察研究武汉、西安等地的气候特点、人群发病特征，从现代医学角度总结发现慢性心理应激、肠道功能、肾素–血管紧张素系统(Renin-Angiotensin System, RAS)、凝血机制也会引发肝损伤；从传统中医角度认为通过解剖毗邻、经络相通、气血升降、五行克侮、五脏一体观等引发肝损伤。进一步总结发现新冠肝损伤对于认识病毒及其发病机制、提高临床诊治效率具有重要研究意义，为后续研究新冠肝损伤的机制、治疗、预后提供重要线索。

Abstract: Liver damage caused by Coronavirus Disease 2019 (COVID-19) is not uncommon in the clinic. It is currently believed that the causes of liver damage caused by COVID-19 are closely related to virus-es, inflammation, drugs and hypoxia. In this paper, the corresponding author observed and studied the climate characteristics and population morbidity characteristics in Wuhan and Xi’an, and con-cluded from the perspective of modern medicine that chronic psychological stress, intestinal func-tion, Renin-Angiotensin System (RAS) and coagulation mechanism can also cause liver injury. From the perspective of traditional Chinese medicine, it is believed that liver injury can be caused by an-atomical adjacency, interlinking of channels and collaterals, rising and falling of qi and blood, the five elements and the five visceraorganic whole. In conclusion, it is of great research significance to understand the virus and its pathogenesis, improve the efficiency of clinical diagnosis and treat-ment, and provide important clues for the follow-up study on the mechanism, treatment and prog-nosis of liver injury of COVID-19.