最新研究：不明病因儿童肝炎更可能是新冠后遗症
<div style="max-width: 100%;overflow:hidden;"><p style="text-align: center;margin-bottom: 0em;"><span style="color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif; letter-spacing: 0.544px; text-align: justify; caret-color: rgb(34, 34, 34); font-size: 15px;">日前，来自以色列施耐德儿童医学中心、贝林森医院、兰巴姆医学中心和特拉维夫大学的研究人员在《儿科胃肠病学与营养》期刊发表题为《儿童长期新冠肺炎的肝脏表现》的论文，文章分析了施耐德儿童医学中心接收的5名不明病因儿童肝炎患者的临床表现和实验室检验结果，</span><strong style="color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; caret-color: rgb(34, 34, 34);"><span style="font-size: 15px; color: rgb(0, 112, 192);">认为所谓的“不明病因儿童肝炎”更可能由新冠病毒感染导致，腺病毒不是罪魁祸首。</span></strong><span style="color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif; letter-spacing: 0.544px; text-align: justify; caret-color: rgb(34, 34, 34); font-size: 15px;">该论文已经过同行评审。</span></p><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;text-align: center;visibility: visible;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;visibility: visible;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;color: rgb(127, 127, 127);letter-spacing: 0.544px;text-align: justify;caret-color: rgb(255, 0, 0);visibility: visible;line-height: 22.399999618530273px;font-size: 15px;font-family: -apple-system, system-ui, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;display: inline !important;">图源：视觉中国</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;visibility: visible;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;">文章介绍，</span><strong><span style="margin: 0px;padding: 0px;font-size: 15px;color: rgb(0, 112, 192);">5名患者在出现肝炎症状前均曾感染新冠病毒：</span></strong></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;visibility: visible;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;"><strong mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;visibility: visible;font-size: 17px;line-height: 27.200000762939453px;box-sizing: border-box !important;word-wrap: break-word !important;">病例一</strong>是一名3个月大的婴儿在新冠病毒检测阳性21天后出现急性肝功能衰竭并接受肝移植，入院后其新冠病毒、腺病毒检测均为阴性；</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;visibility: visible;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;"><strong mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;visibility: visible;font-size: 17px;line-height: 27.200000762939453px;box-sizing: border-box !important;word-wrap: break-word !important;">病例二</strong>是一名5个月大的婴儿，因发烧、黄疸和肝肿大住院，病情恶化并进行肝移植，入院后新冠病毒和腺病毒检测均呈阳性；</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;"><strong mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;font-size: 17px;line-height: 27.200000762939453px;box-sizing: border-box !important;word-wrap: break-word !important;">病例三</strong>是一名8岁男孩，在新冠病毒检测阳性130天后开始出现腹痛、呕吐和黄疸等肝炎症状，入院后新冠病毒和腺病毒检测均为阴性；</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;"><strong mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;font-size: 17px;line-height: 27.200000762939453px;box-sizing: border-box !important;word-wrap: break-word !important;">病例四</strong>也是一名8岁男孩，在新冠病毒检测阳性90天后开始出现高烧、黄疸、腹泻等肝炎症状，入院后新冠病毒和腺病毒检测均为阴性；</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;"><strong mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;font-size: 17px;line-height: 27.200000762939453px;box-sizing: border-box !important;word-wrap: break-word !important;">病例五</strong>是一名13岁男孩，该病例在新冠病毒检测阳性时伴有无力、腹泻、黄疸等症状，医院认为无需治疗并在39天后“自愈”，但在<span mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;color: rgb(51, 51, 51);text-align: justify;line-height: 27.200000762939453px;font-size: 15px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;display: inline !important;">“自愈”</span>的14天后又出现呕吐、腹痛、黄疸、肝肿大和肝损伤等症状，其腺病毒检测为阳性。</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;">研究人员发现，这种不明<span mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;color: rgb(51, 51, 51);text-align: justify;line-height: 27.200000762939453px;font-size: 15px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;display: inline !important;">病因</span>肝炎在婴儿和儿童身上的表现有所不同，两名婴儿均出现了急性肝功能衰竭，而另外3名8岁以上儿童则主要表现为急性肝炎和胆汁淤积。</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;">针对甚嚣尘上的腺病毒感染导致不明<span mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;color: rgb(51, 51, 51);text-align: justify;line-height: 27.200000762939453px;font-size: 15px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;display: inline !important;">病因</span>儿童肝炎的假说，研究人员专门分析了上述患者的肝脏活检样本，结果没有发现任何腺病毒抗原，也没有腺病毒肝炎的组织学特征，因此</span><strong><span style="margin: 0px;padding: 0px;font-size: 15px;color: rgb(0, 112, 192);">“不认为腺病毒感染是肝炎的罪魁祸首”。</span></strong></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;">研究人员指出，</span><strong><span style="margin: 0px;padding: 0px;font-size: 15px;color: rgb(0, 112, 192);">新冠病毒可通过两种途径导致肝炎。一是新冠病毒直接通过胆管细胞上丰富的ACE2受体侵犯肝脏，即“直接病毒损伤”</span></strong><span style="margin: 0px;padding: 0px;font-size: 15px;"><span mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;color: rgb(0, 122, 170);line-height: 27.200000762939453px;font-size: 15px;box-sizing: border-box !important;word-wrap: break-word !important;"><strong mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;font-size: 17px;line-height: 27.200000762939453px;box-sizing: border-box !important;word-wrap: break-word !important;">，</strong></span>其依据是上述5名患者均为无症状或轻症的新冠病例，不太可能是炎症风暴导致的肝脏损伤；</span><strong><span style="margin: 0px;padding: 0px;font-size: 15px;color: rgb(0, 112, 192);">另一种是新冠病毒感染导致的免疫系统失调，</span></strong><span style="margin: 0px;padding: 0px;font-size: 15px;">其依据是病例二出现了名为继发性噬血细胞性淋巴组织细胞增多症 (HLH) 的全身性炎症综合征，且按照这种假设给予类固醇药物治疗后，多名患者出现了好转。</span></section><section style="font-style: normal;font-variant-caps: normal;font-weight: 400;orphans: auto;text-indent: 0px;text-transform: none;white-space: normal;widows: auto;word-spacing: 0px;-webkit-text-size-adjust: auto;-webkit-text-stroke-width: 0px;text-decoration: none;margin: 0px 16px 16px;padding: 0px;font-size: 17px;text-align: justify;outline: 0px;max-width: 100%;clear: both;min-height: 1em;caret-color: rgb(34, 34, 34);color: rgb(34, 34, 34);letter-spacing: 0.5440000295639038px;line-height: 2em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="margin: 0px;padding: 0px;font-size: 15px;">尽管该论文中涉及的病例有限，但论文作者之一、施耐德儿童医学中心儿童胃肠病学专家怀斯伯德∙津曼在接受以色列媒体采访时表示，全面检查发现，所有5名儿童之前都感染过新冠病毒并且没有接种疫苗，之后他们又接收了8名患有不明<span mp-original-font-size="17" mp-original-line-height="27.200000762939453" style="margin: 0px;padding: 0px;outline: 0px;max-width: 100%;color: rgb(51, 51, 51);text-align: justify;line-height: 27.200000762939453px;font-size: 15px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;box-sizing: border-box !important;word-wrap: break-word !important;display: inline !important;">病因</span>肝炎的儿童，也只能识别出与新冠病毒感染之间的关系。目前这组严重肝炎病例和新冠病毒之间的联系让他们得出结论——这种情况是“长期新冠”的结果。</span><strong><span style="margin: 0px;padding: 0px;font-size: 15px;color: rgb(0, 112, 192);">新冠病毒更有可能是不明病因儿童肝炎的主要成因。</span></strong></section>
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