天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (7): 588-591.doi: 10.11958/20200360

• 新冠专题 • 上一篇    下一篇

石家庄地区新型冠状病毒肺炎患者的临床特征及影像学分析

赵磊1 ，薛剑2 ，王瑜玲1△，戴二黑3 ，许尊贵1 ，李雅楠4 ，敦子倩1 ， 高会霞3 ，戎燕筱4 ，陈灿1   

  1. 1石家庄市第五医院内二科（邮编050000），2结核科，3检验科；4河北省雄安新区雄县医院检验科
  • 收稿日期:2020-03-04 修回日期:2020-04-08 出版日期:2020-07-15 发布日期:2020-07-16
  • 作者简介:赵磊（1982），男，硕士，副主任医师，主要从事呼吸内科疾病研究

The clinical feature and imaging analysis of patients with new coronavirus infection in Shijiazhuang

ZHAO Lei1 , XUE Jian2 , WANG Yu-ling1△, DAI Er-hei3 , XU Zun-gui1 , LI Ya-nan4 , DUN Zi-qian1 , GAO Hui-xia3 , RONG Yan-xiao4 , CHEN Can1   

  1. 1 The Second Internal Medicine, 2 Department of Tuberculosis, 3 Department of Laboratory Medicine, the Fifth Hospital of Shijiazhuang, Shijiazhuang 050000, China; 4 Department of Laboratory Medicine, the Hospital of Xiongan New Area
  • Received:2020-03-04 Revised:2020-04-08 Published:2020-07-15 Online:2020-07-16

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摘要： 目的 分析石家庄地区新型冠状病毒肺炎（COVID-19）患者的临床特征及影像学特点。方法 以2020年 1月21日—2月10日石家庄市第五医院收治的21例COVID-19患者为研究对象，回顾性分析患者的人口学特征、临 床资料、实验室指标及肺部影像学特征。根据年龄分为2组：<45岁组（n=13），≥45岁组（n=8），比较2组上述指标的 差异。结果 21 例 COVID-19 患者中男 14 例，女 7 例；有 7 组家庭聚集性发病（共 19 例）。临床体征：发热 15 例 （71.4%），咳嗽 9 例（42.9%），无任何临床症状 5 例（23.8%）。实验室检查：T 淋巴细胞亚群 CD3＋ 计数降低 8 例 （38.1%），CD4＋计数降低12例（57.1%），CD8＋计数降低6例（28.6%），白细胞计数降低2例（9.5%），中性粒细胞（N）计 数降低2例（9.5%），淋巴细胞（L）计数降低5例（23.8%），C反应蛋白（CPR）升高10例（47.6%）。年龄≥45岁组及<45 岁组患者CD3＋计数、CD4＋计数、CD8＋计数、白细胞计数、N及L计数及其降低比例、CRP水平及CRP升高比例比较， 差异均无统计学意义（P＞0.05）。21例患者中，3例胸部CT检查未见异常；入院前首次影像学检查为胸部X线者11 例，胸部CT者10例，其中胸部X线检查假阴性6例（漏诊率54.5%），而胸部CT检查均呈阳性。结论 石家庄地区 COVID-19感染以家族聚集性为主，T淋巴细胞亚群降低较为明显，早期胸部X线检查极易漏诊。

关键词: 冠状病毒属；肺炎, 病毒性；新型冠状病毒肺炎；新型冠状病毒；T淋巴细胞亚群；石家庄；影像学特点

Abstract: Objective To investigate clinical features and imaging manifestation of patients with the COVID-19 infection in Shijiazhuang. Methods A total of 21 patients with COVID-19 admitted in the fifth hospital in Shijiazhuang from January 21 to February 10, 2020 were selected as the research subjects. The demographic characteristics, clinical data, laboratory indexes and pulmonary imaging characteristics of patients were retrospectively analyzed. According to the age, the patients were divided into two groups: group<45 years old (n=13) and group≥45 years old (n=8). The differences in the above indicators were compared between the two groups. Results Of the 21 COVID-19 patients, 14 were male (66.7%) and 7 were female (33.3%). There were 7 families with clustered incidence (n=19). Clinical signs included fever in 15 cases (71.4%), cough in 9 cases (42.9%) and no clinical symptoms in 5 cases (23.8%). Results of laboratory examination showed that T lymphocyte subsets CD3＋ decreased in 8 cases (38.1%), CD4+ decreased in 12 cases (57.1%), CD8+ decreased in 6 cases (28.6%), leukocyte decreased in 2 cases (9.5%), neutrophil decreased in 2 cases (9.5%), lymphocyte decreased in 5 cases (23.8%), and C-reactive protein (CPR) elevated in 10 cases（47.6%）. There were no significant differences in CD3+ , CD4+ , CD8+ , leukocyte count, neutrophil and lymphocyte and CRP levels between the two age groups (P＞0.05). Of the 21 patients with COVID-19, 3 cases showed no abnormalities in CT examination. The first imaging examination before admission included chest X-rays in 11 cases and lung CT imaging in 10 cases. There were 6 cases of false negative in chest X-ray examination (missed diagnosis rate 54.5%). The lung CT examination showed positive in all 11 cases. Conclusion The COVID-19 infected patients in Shijiazhuang are mainly family-clustered cases. The T lymphocyte subtypes decrease significantly. The early chest X-ray imaging is easily misdiagnosed for COVID-19 infection

Key words: coronavirus, pneumonia, viral, COVID-19, SARS-CoV-2, T-lymphocyte subsets, Shijiazhuang, imaging features