摘要
目的探讨家庭群居爆发型新型冠状病毒肺炎(简称"新冠肺炎")(novel coronavirus pneumonia),NCP的临床与胸部HRCT表现特点。方法收集2020年2月3所医院经核酸检测阳性确诊的新冠肺炎患者10例(4个家庭),其中男性6例(中位年龄60.5岁),女性4例(中位年龄59岁)。所有患者均接受胸部CT扫描并行薄层HRCT重建,由两名10年以上工作经验放射科医生共同阅片分析新冠肺炎HRCT病变发生部位、形态、分布、密度等特点,以及治疗前后HRCT征象变化。并收集临床和实验室指标进行分析和总结。结果本组4个家庭中首例确诊病例均有武汉确诊病例或武汉疫区接触史,4例为输入型病例(占40%),平均潜伏期5 d。实验室检查中5例(50%)外周血白细胞总数降低,4例(40%)淋巴细胞明显降低;8例(80%)C-反应蛋白增高,10例(100%)乳酸脱氢酶增高。10例(100%)患者胸部CT均有阳性表现,其中7例(70%)表现为双肺散在分布磨玻璃密度影(ground glass opacity,GGO),病变界限大多清楚。8例(80%)累及多个肺叶,2例(20%)为单肺叶病变。绝大多数病灶位于胸膜下和肺外周处,以双肺下叶为著。5例患者(50%)病变内可见细支气管充气征,9例患者(90%)病变内可见增粗细小血管影。7例患者(70%)治疗后复查胸部CT,3例(30%)原肺内胸膜下病变出现不同程度实变及纤维化,2例(20%)实变影转变为GGO,1例(10%)原肺内GGO消失,又出现新发GGO,1例(10%)病变范围有增大。结论新冠肺炎具有家庭群居爆发的特点,均可有输入性病例,潜伏期较短,其胸部HRCT表现具有一定特征性,且有助于治疗后患者病变动态观察;结合流行病学和实验室检查有助于对NCP做出临床诊断和提供疫情防控的可靠依据。
Objective To explore the characteristics of clinical and chest HRCT in the family group outbreak of novel coronavirus pneumonia(NCP).Methods Ten cases(4 families)of confirmed NCP patients were recruited from 3 hospitals in February 2020,with 6 cases of men(median age 60.5 years)and 4 cases of women(median age 59 years).All patients accepted chest CT scans,and the HRCT images characteristics before and after treatment were analyzed by two radiologists with more than 10 years of work experiences.And all the laboratory test indicators were also analyzed.Results The first confirmed cases in 4 families were imported cases,all of the 4 cases(40%)have the history of confirmed cases contacted,working experience in Wuhan area or contact history of epidemic areas.The laboratory results showed a decrease in the total number of peripheral white blood cells in 5 cases,a significant decrease in lymphocytes in 4 cases,and an increase in C-reactive protein in 8 cases and lactic acid dehydrogenase increase in all 10 cases.Chest CT was positive in all the patients,and 7 cases showed bilateral lung distribution of ground glass opacity(GGO),mostly of the lesions were clear.2 cases were distributed in single lung lobe,and 1 case showed GGO and focal consolidation in the lower lobe of bilateral lungs.The majority of lesions are located under the pleural,especially in the lower lobes of bilateral lungs.Small thicken vascular shadow(9 cases)and fine air bronchial signs(5 cases)can be seen in some of the cases.7 patients accepted chest CT after treatment.3 cases showed different degrees of consolidation and fibrosis,2 cases showed as GGO changed from consolidation,the original lung GGO disappeared in another case,and new GGO can been seen,1 case showed increased GGO.Conclusion The NCP has the characteristics of family group outbreak,imported cases history,and short incubation period.The chest HRCT performance and laboratory results are helpful for the diagnosis of NCP and dynamic evolution observation.
作者
沈晶
于晶
鄢英男
桑亚荣
秦丽莉
那民
伍建林
SHEN Jing;YU Jing;YAN Yingnan;SANG Yarong;QIN Lili;NA Min;WU Jianlin(Department of Radiology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Radiology,Central Hospital of Huludao,Huludao 125399,China;Department of Radiology,the Sixth People's Hospital of Dalian,Dalian 116001,China)
出处
《大连医科大学学报》
CAS
2020年第1期32-36,共5页
Journal of Dalian Medical University
关键词
新型冠状病毒肺炎
CT
磨玻璃密度影
淋巴细胞
novel coronavirus pneumonia(NCP)
CT
ground glass opacity(GGO)
lymphocytes
