5例普通型新冠肺炎患者临床诊治分析与病毒核酸追踪  

Clinical analysis of 5 cases of common novel coronavirus pneumonia and viral nucleic acid tracking

作　　者：李元军[1,2] 高非凡 倪菁 李百远 李春艳 王改莲 王建清 LI Yuan-jun;GAO Fei-fan;NI Jing;LI Bai-yuan;LI Chun-yan;WANG Gai-lian;WANG Jian-qing(Affiliated Hospital of Yan′an University,Yan′an 716000,China;Yan′an Second People′s Hospital,Yan′an 716000,China)

机构地区：[1]延安大学附属医院,陕西延安716000 [2]延安市第二人民医院,陕西延安716000

出　　处：《延安大学学报（医学科学版）》2020年第1期1-5,9,共6页Journal of Yan'an University:Medical Science Edition

基　　金：陕西省2020年度中医药防治新型冠状肺炎科研应急专项(2020-YJ007);延安大学防治新型冠状肺炎紧急科研专项引导基金(YDKYYJ01);延安市2020年度科技计划“新型冠状病毒感染的肺炎疫情防控”专项(SL2020ZCSY-006)。

摘　　要：目的探讨延安市新型冠状病毒肺炎(简称新冠肺炎,NCP)患者流行病学史、临床特征等。方法回顾性分析延安市第二人民医院2020年1月23日至2020年2月22日收治的5例确诊新冠肺炎患者的流行病学特点、临床症状、实验室检查、CT影像表现及治疗转归等资料。结果延安市5例NCP患者年龄18~60岁,平均年龄42岁,男性4例(80%),女性1例(20%),均有明确的流行病史,其中2例(40%)属于家庭聚集性发病;临床上可见乏力(5,100%)、发热(4,80%)、咳嗽、咳痰(3,60%)、咽干咽痛(2,40%)、腹泻(2,40%)、胸痛(1,20%),其中以乏力为首发症状的3例(60%)、发热3例(60%)、咳嗽2例(40%);实验室检查中4例(80%)可出现淋巴细胞减低,血沉、C反应蛋白升高,3例(60%)治疗过程中出现丙氨酸氨基转移酶(ALT)、天门冬氨基转移酶(AST)升高,较少出现白细胞、中性粒细胞、降钙素原升高;胸部CT双肺均有典型磨玻璃样改变,多见于肺下叶、外带,且变化较快,3例(60%)于病程后期出现肺部纤维化病灶;鼻拭子、咽拭子、肛拭子、粪便核酸检测平均阴转时间为9.4 d、9 d、>31.25 d、>34 d;5例患者均为普通型病例,给予抗病毒、抗感染、对症等治疗,均好转出院,平均住院时间16.8天。结论延安市NCP患者以输入型为主,以男性居多,人群普遍易感,临床以普通型为主,以乏力、发热(中等热度)为主要首发症状,实验室检查多见淋巴细胞减低,C反应蛋白、血沉升高,有典型的胸部CT表现以及病毒核酸检测阳性,给予抗病毒、抗感染、对症等治疗后均好转出院。Objective To investigate the epidemiological history and clinical characteristics of patients with Novel Coronavirus Pneumonia(NCP)in Yan′an.Methods Retrospective analysis of the epidemiological characteristics,clinical symptoms,laboratory tests,CT imaging manifestations,and treatment outcomes of 5 patients diagnosed with NCP admitted to Yan′an Second People′s Hospital from January 23,2020 to February 22,2020.Results Five NCP patients in Yan′an were 18~60 years old,with an average age of 42 years.Five males(80%)and one female(20%)had a clear epidemiological history.Two of them(40%)belonged to family clusters.Clinically,fatigue(5,100%),fever(4,80%),cough,sputum(3,60%),dry throat,sore throat(2,40%),diarrhea(2,40%),chest pain(1,20%),including 3 cases(60%)with fatigue as the first symptom,3 cases of fever(60%),and 2 cases of cough(40%).In laboratory tests,4 cases(80%)showed lymphocyte decrease,and ESR and C-reactive protein increased.In 3 cases(60%),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)increased during the course of treatment.Leukocytes,neutrophils,and procalcitonin were less frequent.Chest CT both lungs have typical ground-glass changes,which are more common in the lower lobe and outer bands,and change rapidly.Three patients(60%)developed pulmonary fibrosis lesions later in the course of the disease.Nasal swabs,throat swabs,anal swabs,and fecal nucleic acid tests had an average negative conversion time of 9.4 d,9 d,>31.25 d,and>34 d.The five patients were all ordinary cases.They were given antiviral,anti-infective,and symptomatic treatments.They all improved and were discharged from hospital with an average hospital stay of 16.8 days.Conclusion The NCP patients in Yan′an are mainly of the input type,mostly male,and the population is generally susceptible.The clinical type is mainly of the ordinary type,and the main symptoms are fatigue and fever(medium fever).In laboratory tests,lymphocytes are often reduced,and C-reactive protein and erythrocyte sedimentation are elevated.There

关 键 词：新型冠状病毒 NCP COVID-19 核酸检测 临床特征 治疗 

分 类 号：R4[医药卫生—临床医学]