摘要
目的分析宜城地区新型冠状病毒肺炎(COVID-19)患者各方面情况,发病早期胸部电子计算机断层扫描(computed tomography,CT)影像表现与临床特点,进一步了解COVID-19的发病特点。方法回顾性分析2020年1月16日至2月9日在湖北省宜城市人民医院确诊为COVID-19的66例患者资料。所有患者在初次就诊时进行了实验室检查、胸部CT检查。对患者基本信息、实验室检查结果、患者发病早期胸部CT影像特征等进行调查分析,并且总结发病规律。结果66例COVID-19患者年龄21~71岁,按照入院时病情程度分为轻型4例、普通型51例、重型6例和危重型5例。主要症状依次为发热、咳嗽、乏力。实验室检查发现:血常规中淋巴细胞百分比下降,C反应蛋白升高,血沉升高,嗜酸性粒细胞下降。生物化学检测结果中丙氨酸氨基转移酶、门冬氨酸氨基转移酶升高,血尿素氮、血肌酐下降,白蛋白下降。重型和危重型患者B型钠尿肽、纤维蛋白原、D-二聚体升高明显。患者胸部CT结果显示,轻型患者胸部CT影像学检查无明显异常;普通型病例中单发病灶15例(29.41%),多发病灶36例(70.59%);重型病例中单发病灶1例(16.67%),多发病灶5例(83.33%);危重型病例均为多发病灶。普通型、重型、危重型患者胸部CT影像均以斑片状高密度影和磨玻璃影为主要表现。结论宜城地区COVID-19患者的各项实验室指标有明显变化,患者发病早期CT影像主要表现为斑片状高密度影和磨玻璃影,部位以双肺、胸膜下及肺野外带多见。此结果对于新型冠状病毒感染的早期诊断和治疗具有参考价值。
Objective To analyze the early stage characteristics COVID-19 in Yicheng area in terms of computed tomographic(CT)imaging and clinical features.Methods The data of 66 patients with COVID-19 diagnosed in Yicheng People’s Hospital from January 16 to February 9,2020 were analyzed retrospectively.All patients underwent laboratory examination and chest CT examination at the first visit.The basic information of patients,laboratory examination results,and chest CT image characteristics of patients in the early stage of onset were analyzed and summarized.Results Totally 66 COVID-19 patients were 21-71 years.Based on the degree of illness on admission,they were divided into mild type(n=4),common type(n=51),severe type(n=6),and critical type(n=5).The main symptoms were fever,cough,and fatigue.Laboratory examination showed that lymphocyte percentage decreased,C-reactive protein increased,erythrocyte sedimentation rate(ESR)increased,eosinophils(EOS)decreased,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)increased,blood urea nitrogen(BUN)and creatinine(CREA)decreased,and albumin(ALB)decreased.Brain natriuretic peptide(BNP),fibrin(FIB),and D-Dimer(D-D)increased significantly in severe and critical patients.The chest CT results showed no obvious abnormality in the chest CT imaging examination of mild patients.15 cases(29.41%)had single lesion and 36 cases(70.59%)had multiple lesions in common type cases.1 case(16.67%)had single lesion and 5 cases(83.33%)had multiple lesions in severe cases.The main manifestations of chest CT images of common type,severe type and critical type patients were patchy high-density shadow and ground glass shadow.Conclusion The laboratory indexes of COVID-19 patients in Yicheng area had obvious changes.In the early stage of the disease,the main CT manifestations were patchy high-density shadow and ground glass shadow.The location of the lesions was double lung,subpleural and lung field zone.This result has a strong reference value for the early diagnosis and treatment of viral infection.
作者
姚春勇
李杨帆
贾原菊
Yao Chunyong;Li Yangfan;Jia Yuanju(Department of Respiratory Medicine,Yicheng People s Hospital,Yicheng 441499,Hubei Province,China;Department of Traditional Chinese Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Oncology Medicine,Yicheng People s Hospital,Yicheng 441499,Hubei Province,China)
出处
《首都医科大学学报》
CAS
北大核心
2020年第6期997-1001,共5页
Journal of Capital Medical University
关键词
新型冠状病毒肺炎
回顾性研究
分型
novel coronavirus pneumonia
a retrospective study
typing
