摘要
目的探讨新型冠状病毒肺炎(COVID-19)患者的流行病学,分析其临床表现,为制定恰当的干预措施提供依据。方法回顾性分析2020年1月22日—2月19日期间阜阳市第二人民医院已治愈出院的36例新型冠状病毒患者流行病学、临床表现、血清化验结果、CT表现和药物使用情况。结果首例患者为输入型病例,患者有3年武汉居住史,在武汉接触史不详;其余35例患者中9例与至少1例新型冠状病毒肺炎确诊患者有过直接接触,26例患者接触史不详。36例患者中男21例(58.33%),女15例(41.67%),年龄8~57(38.61±10.57)岁。合并高血压3例,精神病、抑郁症、胆结石、肝硬化、糖尿病、乙型肝炎、艾滋病、脑梗死各1例。31例新型冠状病毒患者首发症状为发热,5例患者首发症状不发热,其中1例患者伴随症状出现发热,体温37.3~38.5℃,发热时间3~14(10.18±2.83)d;部分患者还表现出干咳、咽干、咽痛、腹泻、咯痰、胸闷、流涕、无力、气喘等症状。潜伏期2~12(4.96±2.13)d;就诊时病程3~11(5.55±1.43)d;住院时间10~24(15.11±3.78)d。实验室检查:WBC(5.24±2.11)×109/L,N(3.75±1.73)×109/L,L(1.05±0.54)×109/L,CRP(31.47±17.28)mg/L,PCT(0.08±0.03)ng/ml。36例患者中23例出现双肺斑片状密度增高影,表现为磨玻璃样高密度灶,可见肺纹理结构或大片状渗出和实变,提示肺间质和实质炎性反应。4例单一右肺病变,1例单一左肺病变,7例表现出索条或絮片状密度增高影。36例患者均给予洛匹那韦/利托那韦(克力芝)治疗,常用药物包括泼尼松、莫西沙星、连花清瘟胶囊、干扰素等。36例全部治愈出院。结论新型冠状病毒肺炎主要症状为发热、咳嗽,发病以中年人群为主,病程约为4周,血清炎性因子提示存在感染,患者多表现出异常胸部CT影像,合理且规范地使用抗病毒药物和糖皮质激素是改善新型冠状病毒肺炎患者疗效的重要措施。
Objective To investigate the coronavirus disease 2019 patients'epidemiology and analyze their clinical manifestations,so as to provide evidence for making appropriate intervention measures.Methods The coronavirus disease 2019 patients who had been cured and discharged in Fuyang Second People's Hospital from January 22,2020 to February 19th were retrospectively analyzed.The epidemiology,clinical manifestations,serum test results,CT findings and drug use were analyzed.Results 36 cases of new coronavirus were cured and discharged.Results The first patient was an imported case.The patient has lived in Wuhan for 3 years,and the contact history in Wuhan is unknown.Novel coronavirus pneumoniae was diagnosed in 9 of the remaining 35 patients and at least 1 case were diagnosed with direct coronavirus pneumonia.The contact history of 26 patients was unknown.Among the 36 patients,21 were male(58.33%),15 were female(41.67%),and the age was 8-57(38.61±10.57)years.There were 3 cases with hypertension,1 case with psychosis,1 case with depression,1 case with gallstone,1 case with cirrhosis,1 case with diabetes,1 case with hepatitis B,1 case with AIDS and 1 case with cerebral infarction.31 novel coronavirus patients had the first symptom of fever,5 patients had no fever at first symptom,1 of them had fever,temperature 37.3-38.5 degrees,fever time 3-14(10.18±2.83)d,and some patients also showed dry cough,pharynx,pharynx,diarrhea,phlegm,chest tightness,runny nose,weakness,asthma and so on.The incubation period was 2-12(4.96±2.13)days;the course of disease was 3-11(5.55±1.43)days;the length of stay was 10-24(15.11±3.78)days.Laboratory test:WBC(5.24±2.11)×109/L,N(3.75±1.73)×109/L,L(1.05±0.54)×109/L,CRP(31.47±17.28)mg/L,PCT(0.08±0.03)ng/ml.In the 36 patients,23 of them had double lung patchy density increasing shadow,which showed ground glass like high density foci,and showed lung texture structure or large-scale exudation and consolidation,suggesting inflammatory reaction of lung interstitium and parenchyma.There were 4 cases with single right lung disease,1 case with single left lung disease,and 7 cases with high density shadow.All the 36 patients were treated with clopinavir/ritonavir,including prednisone,moxifloxacin,Lianhuaqingwen capsule,interferon,etc.36 cases were cured and discharged.Conclusion Coronavirus disease 2019 is novel coronavirus pneumonia.The main symptoms are fever and cough.The main cause of the disease is middle-aged people.The duration of the disease is about 4 weeks.The serum inflammatory factors suggest infection.Patients often show abnormal chest CT images.Rational and standardized use of antiviral drugs and glucocorticoids is an important measure to improve the curative effect of coronavirus disease 2019.
作者
尚晓娟
刘海军
朱丽红
何梅梅
辛克锋
Shang Xiaojuan;Liu Haijun;Zhu Lihong;He Meimei;Xin Kefeng(Department of Hepatology, Fuyang City Second People Hospital,AnHui Province, Fuyang 236000, China;不详)
出处
《疑难病杂志》
CAS
2020年第6期563-565,573,共4页
Chinese Journal of Difficult and Complicated Cases
基金
国家“十三五”科技重大专项(2018ZX10715506-001)。
关键词
新型冠状病毒肺炎
临床表现
血清炎性因子
CT影像
Coronavirus disease 2019
Clinical characteristic
Serum inflammatory cytokines
Computed tomography
