天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (7): 599-602.doi: 10.11958/20200773

• 新冠专题 • 上一篇    下一篇

合并冠心病与否对新型冠状病毒肺炎患者疾病发展及预后的影响

彭明，李玉凯，王岚，肖杰，成忠△   

  1. 武汉市第四医院，华中科技大学同济医学院附属普爱医院心内科（邮编 430022）
  • 收稿日期:2020-04-01 修回日期:2020-05-03 出版日期:2020-07-15 发布日期:2020-07-16
  • 作者简介:彭明（1986），男，硕士，主治医师，主要从事心血管内科基础及临床研究

The influence of coronary heart disease on the development and prognosis of COVID-19 patients

PENG Ming, LI Yu-kai, WANG Lan, XIAO Jie, CHENG Zhong△   

  1. Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2020-04-01 Revised:2020-05-03 Published:2020-07-15 Online:2020-07-16

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摘要： 目的 探讨合并冠心病（CHD）与否对新型冠状病毒肺炎（COVID-19）患者疾病发展及预后的影响。方 法 回顾性分析我院治愈出院的80例COVID-19患者，其中普通型58例、重型14例、危重型8例。按照是否合并 CHD分为2组：合并CHD组36例，未合并CHD组44例。比较2组患者年龄、性别、体质量指数、血氧饱和度、心率、血 压、住院天数、胸部CT明显好转所需天数、临床分型、血管紧张素转换酶抑制剂（ACEI）/血管紧张素Ⅱ受体拮抗剂 （ARB）用药情况等一般资料，以及白细胞计数（WBC）、淋巴细胞计数（LYM）、C反应蛋白（CRP）、肝肾功能等检查结 果的差异。结果 合并CHD组较未合并CHD组患者血氧饱和度降低，心率增快，住院天数、胸部CT好转所需天数延 长，服用ACEI/ARB类药物的患者所占比例升高（均P＜0.05）。合并CHD组较未合并CHD组患者WBC、LYM降低， CRP升高（P＜0.05）。合并CHD组患者重型、危重型所占比例均明显高于未合并CHD组，服用ACEI/ARB类药物的 COVID-19患者重型、危重型所占比例均高于未服用药物患者（P＜0.05）。结论 合并CHD的COVID-19患者病情 更严重。同时，ACEI/ARB类药物的使用有可能加重COVID-19患者的病情。

关键词: 肺炎, 病毒性；冠心病；病人病情；预后；血管紧张素转换酶抑制药；血管紧张素受体拮抗剂；新型冠状病 毒肺炎；血管紧张素转化酶2

Abstract: Objective To investigate the effect of coronary heart disease (CHD) on the development and prognosis of corona virus disease 2019 (COVID-19) patients. Methods Eighty cases of COVID-19 cured and discharged from our hospital were analyzed retrospectively, including 58 cases of common type, 14 cases of severe type and 8 cases of critical type. The patients were divided into two groups: 36 patients with CHD and 44 patients without CHD. The general data including age, sex, body mass index, blood oxygen saturation, heart rate, blood pressure, days of hospitalization, days needed for obvious improvement of pulmonary CT, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) medication and disease classification were compared between the two groups. The test results including white blood cell count (WBC), lymphocyte count (LYM), C-reactive protein (CRP), liver and kidney function were also compared between the two groups. Results Compared with the patients without CHD, the patients with CHD showed lower blood oxygen saturation, faster heart rate, longer hospital stay, longer days for improvement of chest CT and higher proportion of patients taking ACEI/ARB drugs (all P＜0.05). The levels of WBC and LYM were significantly lower in the patients with CHD than those without CHD, while the level of CRP was higher (P＜ 0.05). The proportion of severe and critical patients with CHD was significantly higher than that of patients without CHD, and the proportion of severe and critical patients with COVID-19 taking ACEI/ARB drugs was higher than that of patients without taking drugs (P＜0.05). Conclusion The condition of COVID-19 patients with CHD is more serious. ACEI/ARB drugs may aggravate the condition of patients with COVID-19.

Key words: pneumonia, viral, coronary disease, patient acuity, prognosis, angiotensin-converting enzyme inhibitors; angiotensin receptor antagonists, COVID-19, ACE2