摘要
目的分析武汉市100例新型冠状病毒肺炎(COVID-19)患者治疗前后的临床特征.方法收集2020年1月29日~3月11日武汉市某医院收治的确诊COVID-19病例,回顾性分析临床特征及治疗前后实验室、影像学改变.结果本研究共纳入100例确诊的COVID-19患者,其中男67例,女33例,年龄8~97岁,非重症89例,重症11例;平均住院日(15.01±9.43)d.基础疾病为高血压病(12%)者最多;首发症状多为咳嗽(66%).治疗前,(61.54%)T淋巴细胞总数(CD3+)、(67.69%)T辅助淋巴细胞(CD4^+)、(60%)T抑制淋巴细胞(CD8+)减少;(81%)C反应蛋白(CRP)、(60.67%)白介素-6(IL-6)、(27.27%)D-二聚体(D-D)计数升高.CT表现为双肺病斑片状磨玻璃影,双肺病变显著高于单肺病变(36%).治疗后,大部分患者的淋巴细胞CD3^+、CD4+、CD8+计数恢复正常,CRP、IL-6、D-D计数有所下降.99例(99%)治愈出院,1例死亡(1%).结论COVID-19在伴有基础疾病老年人中容易发展为重症.淋巴细胞、CD3^+、CD4^+、CD8^+、CRP、IL-6、D-D可作为病情进展观察指标.胸部CT可作为本病的早期筛查和诊断手段.
Objective To analyze the clinical characteristics of 100 cases of coronavirus disease 2019(COVID-19)in Hubei before and after treatment.Methods Conlinned COVID-19 cases admitted to a hospital in Wuhan from January 29 to March 11,2020 were enrolled.Clinical characteristics and laboratory and imaging changes of these patients were retrospectively analyzed.Results A total of 67 male patients and 33 female patients aged 8-97 years were included,including 89 non-critical cases and 11 critical cases.The average length of stay was(15.01±9.43)d.Most(12%)of the patients were known with underlying disease of hypertension.Cough was the most common initial symptom in about 66%of the patients.Before treatment,the total counts of T lymphocytes(CD3^+,61.54%),T helper lymphocytes(CD4^+,67.69%)and T suppressor lymphocytes(CD8^+,60%)of the patients decreased,and the counts of C-reactive protein(CRP,81%),interleukin-6(IL-6,60.67%)and D-dimer(D-D,27.27%)increased.Patchy ground glass opacity was noted in both lung fields on CT.The proportion of patients with bilateral lung lesions was significantly higher than that of the patients with unilateral lung lesions(36%).After treatment,the counts of CD3^+,CD4^+and CD8^+returned to normal levels in most of the patients,and CRP,IL-6,D-D were reduced.Ninety nine patients(99%)were cured and discharged,one patient(1%)died.Conclusion COVID-19 tends to develop into severe disease in elderly patients with underlying diseases.Lymphocytes,CD3^+,CD4^+,CD8^+,CRP,IL-6 and D-D can be used as indicators to observe the disease progression.Chest CT can be used for early screening and diagnosis of COVID-19.
作者
胡绳
李志伟
肖贞良
Hu Sheng;Li Zhiw-ei;Xiao Zhenliang(Department of Pulmonary and Critical Care Medicine,General Hospital of Western Theater Command of PLA,Chengdu,Sichuan,610083,China)
出处
《西南国防医药》
CAS
2020年第6期493-496,共4页
Medical Journal of National Defending Forces in Southwest China
