天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (7): 583-587.doi: 10.11958/20200400

• 新冠专题 • 上一篇    下一篇

新型冠状病毒肺炎患者的临床特点及与严重程度的 相关性分析

左方田，李长力，董照刚，常新会，贾明雅，魏超，郑喜胜△   

  1. 河南省南阳市中心医院重症医学科（邮编473000）
  • 收稿日期:2020-03-09 修回日期:2020-04-03 出版日期:2020-07-15 发布日期:2020-07-16
  • 作者简介:左方田（1993），女，硕士，住院医师，主要从事重症与危重症患者诊疗方面研究

Analysis of the correlation between clinical characteristics and disease severity in patients with novel coronavirus pneumonia

ZUO Fang-tian, LI Chang-li, DONG Zhao-gang, CHANG Xin-hui, JIA Ming-ya, WEI Chao, ZHENG Xi-sheng△   

  1. Department of Intensive Care Unit, Nanyang Central Hospital, Nanyang 473000, China
  • Received:2020-03-09 Revised:2020-04-03 Published:2020-07-15 Online:2020-07-16

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摘要： 目的 探讨新型冠状病毒肺炎（新冠肺炎）患者的临床特点及与疾病严重程度的相关性，为快速评估病情 及预测预后提供依据。方法 收集南阳市中心医院新冠肺炎患者的资料，根据其临床分型分为非重症组和重症组， 比较2组之间基本情况、实验室及影像学检查结果的差异。结果 50例患者中男18例（36%），女32例（64%），平均 年龄（48.2±15.3）岁，非重症39例（78%），重症11例（22%），41例（82%）去过武汉或与武汉返程人员密切接触。发热 （98%）、乏力（66%）是最常见的临床症状，29例（58%）出现淋巴细胞（LYM）计数下降，48例（96%）胸部CT表现为多 发小斑片影、间质改变或磨玻璃影。重症组入院时气喘发生率，白细胞计数（WBC）、中性粒细胞（NEU）比值、血清降 钙素原（PCT）、乳酸脱氢酶（LDH）、天冬氨酸转氨酶（AST）水平较高，而氧合指数（OI）、LYM比值低于非重症组（P＜0.05 或P＜0.01），WBC、NEU比值、PCT与病情严重程度呈正相关，LYM比值与病情严重程度呈负相关（P＜0.05）；与非重 症组相比，重症组住院期间所观察时间点的NEU比值较高、LYM比值较低（P＜0.05）。重症组激素及丙种球蛋白的 使用率高，且接受了更多的呼吸机支持治疗（P＜0.05或P＜0.01）。49例（98%）治愈出院，1例危重型患者死亡，病死 率为2.0%，平均住院时间为13（11，16）d。结论 新冠肺炎患者普遍表现为发热、乏力，淋巴细胞降低，年龄、基础疾 病与疾病严重程度无关，而NEU比值、LYM比值可能与病情严重程度有关。

关键词: 冠状病毒属；肺炎, 病毒性；危重病；新型冠状病毒肺炎

Abstract: Objective To investigate clinical characteristics and their correlation with disease severity in patients with novel coronavirus pneumonia (NCP), and provide basis for rapid assessment of the disease and prediction of prognosis. Methods Data of NCP patients in Nanyang Central Hospital were collected. Patients were divided into severe group and non-severe group according to their clinical classification.The basic clinical data, laboratory and imaging examination results were compared between the two groups. Results In the 50 patients, there were 18 males (36%) and 32 females (64%), and the average age was (48.2±15.3) years. Patients included 39 non-severe cases (78%) and 11 severe cases (22%). Forty-one cases (82%) have been to Wuhan or have been in close contact with the people returning from Wuhan. Fever (98%) and fatigue (66%) were the most common clinical symptoms. Twenty-nine cases (58%) showed lymphocyte (LYM) decline, 48 cases (96%) showed multiple plaque shadows, interstitial changes or ground glass shadows in chest CT examination. The incidence of asthma, white blood count (WBC), neutrophils (NEU)%, procalcitonin (PCT), lactate dehydrogenase (LDH) and aspartate transaminase(AST) levels were higher in severe group than those in non-severe group, but OI and LYM% were lower in severe group than those of non-severe group (P＜0.05 or P＜0.01). WBC, NEU% and PCT were positively correlated with the disease severity, while LYM% was negatively correlated with the disease severity (P＜0.05). Compared with the non-severe group, NEU% was higher and LYM% was lower in the severe group (P＜0.05). The usage rates of hormones and gamma globulin were high, and patients received more ventilator support treatment in severe group. Forty-nine cases (98%) were cured and discharged from hospital. One case died in severe group, and the fatality rate was 2%. The median hospital stay was 13(11, 16) days. Conclusion Patients with NCP generally show fever, fatigue and decreased lymphocytes. The age and complications are not related to the severity of the disease. Levels of NEU% and LYM% are likely related to the severity of the disease.

Key words: coronavirus, pneumonia, viral, critical illness, coronavirus disease 2019