摘要
目的回顾性分析新型冠状病毒肺炎(COVID-19)患者的流行病学、临床特征及治疗情况,为COVID-19临床诊疗提供参考。方法选取2020年1月20日至2月10日广州市第八人民医院收治的278例COVID-19确诊患者作为研究对象,收集患者的一般人口学资料、流行病学资料、基础疾病、临床表现、实验室检查、胸部CT影像学资料、治疗及预后等资料进行分析。结果278例患者中男性130例(46.8%),女性148例(53.2%),年龄(48.1±17.0)岁,20~69岁患者占88.8%,236例(84.9%)患者合并有基础疾病,普通型居多211例(75.9%),住院病死率0.4%(1/278)。病例来源以输入性病例为主(201例,72.3%),这其中武汉输入89例(占全部输入性病例的44.3%)。最常见的临床表现为发热(70.9%)和干咳(61.5%)。患者以白细胞正常(79.5%)或减少(16.5%)、淋巴细胞减少(33.5%)多见,部分患者血红蛋白(10.4%)和血小板(12.6%)减少,55.4%患者白蛋白水平降低,肝功能(丙氨酸转氨酶、天冬氨酸转氨酶)、肾功能(肌酐、尿素氮)指标无明显异常,有61例(21.9%)患者伴有乳酸脱氢酶升高,26例(9.4%)患者伴有肌酸激酶升高,52例(18.7%)患者的活化部分凝血活酶时间延长,140例(50.4%)患者D-二聚体升高;C反应蛋白升高有117例(42.1%)。典型的CT表现:疾病早期胸部影像呈现单发或多发磨玻璃阴影,肺外带明显;进展期发展为病灶增多、范围扩大呈双肺多发的磨玻璃影、浸润影或实变影;重型/危重型表现为双肺弥漫性实变伴多发斑片状密度增高影。244例(87.8%)患者接受≥1种的抗病毒药物治疗,242例(87.1%)使用了抗菌药物,191例(68.7%)接受了氧疗,接受中医治疗198例(71.2%)。结论COVID-19各个年龄段均有发病,未见性别差异,以普通型为主,病死率不高;常合并多系统、多器官异常或损害,临床应密切关注病情进展,及时研判病情变化,调整治疗方案,努力提高救治成功率。
Objective To retrospective analyze the epidemiology,clinical characteristics,treatment and prognosis in patients with coronavirus disease 2019(COVID-19).Methods A total of 278 patients with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10,2020 were selected.The general demographic data,epidemiological data,clinical symptoms,laboratory examinations,lung CT imaging,treatment and prognosis were analyzed.Results There were 130 male patients(46.8%)and 148 females(53.2%)with age(48.1±17.0)years and 88.8%patients between 20-69 years.Two hundred and thirty-six(84.9%)patients had comorbidities.Two hundred and eleven cases(75.9%)were common type.The in-hospital mortality was 0.4%(1/278).The majority(201,72.3%)were imported cases mainly from Wuhan(89,44.3%).The most common clinical manifestations were fever(70.9%)and dry cough(61.5%).In some patients,hemoglobin(10.4%),platelets(12.6%)and albumin(55.4%)were lower than the normal range.Other biochemical tests according to liver and function were normal,while lactic dehydrogenase(LDH)was elevated in 61 patients(21.9%),creatine kinase increased in 26 patients(9.4%).Prolonged activated partial thromboplastin time(APTT)was seen in 52 patients(18.7%),D-dimer higher than normal in 140 patients(50.4%),while 117 patients(42.1%)had elevated high-sensitivity C-reactive protein.Typical CT manifestations included single or multiple ground glass shadows especially in lung periphery in early disease which infiltrated and enlarged during progressive stage.Diffuse consolidation with multiple patchy density in severe/critical cases and even"white lung"presented in a few patients.Two hundred and forty-two patients(87.1%)received one or more antiviral agents,242(87.1%)combined with antibacterials,191(68.7%)with oxygen therapy.There were 198 patients(71.2%)treated with traditional Chinese medicine.Conclusions COVID-19 could attack patients in all ages with majority of common type and low mortality rate.Clinical manifestations involve multiple organs or systems.Progression of the disease results in critical status which should be paid much attention.
作者
刘昶权
潘越峻
邓西龙
罗育红
韦广莹
劳婉婷
张国明
罗灿伟
谭杏才
关永佳
雷春亮
Liu Changquan;Pan Yuejun;Deng Xilong;Luo Yuhong;Wei Guangying;Lao Wanting;Zhang Guoming;Luo Canwei;Tan Xingcai;Guan Yongjia;Lei Chunliang(Department of Emergency,Guangzhou Eighth People′s Hospital,Guangzhou 510060,China;Department of Infectious Diseases,Guangzhou Eighth People′s Hospital,Guangzhou 510060,China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2020年第8期598-604,共7页
Chinese Journal of Internal Medicine
基金
广东省防治新型冠状病毒科技攻关专项(2020B111105001)。
关键词
新型冠状病毒肺炎
流行病学
临床特征
治疗
预后
Coronavirus disease 2019
Epidemiology
Clinical characteristics
Treatment
Prognosis
