2019新型冠状病毒感染的肺炎79例临床特征及治疗分析  

Clinical characteristics and treatment strategies of 79 patients with COVID-19

作　　者：房晓伟 梅清[1] 杨田军[1] 张蕾[1] 杨云 王胤中 童飞 叶重阳 高宇 黄耀 耿士窠 潘爱军[1] FANG Xiao-wei;MEI Qing;YANG Tian-jun;ZHANG Lei;YANG Yun;WANG Yin-zhong;TONG Fei;YE Chong-yang;GAO Yu;HUANG Yao;GENG Shi-ke;PAN Ai-jun(Anhui Provincial Hospital, Intensive Care Unit, Hefei 230001, China)

机构地区：[1]安徽省立医院重症医学科,安徽合肥230001

出　　处：《中国药理学通报》2020年第4期453-459,共7页Chinese Pharmacological Bulletin

基　　金：安徽省自然科学基金资助项目(No 1808085MH300)。

摘　　要：目的回顾性分析新型冠状病毒感染的肺炎(COVID-19)患者的临床特征,总结治疗经验,为抗疫一线临床医生提供诊疗参考。方法选取2020年1月22日至2月18日安徽省立医院感染病院收治的79例COVID-19患者为研究对象,其中普通型组55例,重型和危重型组24例。收集并比较两组患者的临床资料,包括一般情况、临床症状、体征、实验室检查、肺部CT影像学及预后等,分析两组患者的治疗方案。结果 79例COVID-19患者平均年龄为45.1±16.6岁,其中男性45例。重型和危重型组较普通组患者的发病年龄更大,男性占比更多,合并更多的基础疾病,差异有统计学意义(P<0.05)。重型及危重型组较普通组患者的淋巴细胞(LYM)计数、白蛋白(ALB)降低更为明显;而中性粒细胞(NEU)百分比、C反应蛋白(CRP)、D二聚体、乳酸脱氢酶(LDH)、肌钙蛋白(cTnI)和尿素氮(BUN)的升高更加显著,差异有统计学意义(P <0. 05)。重型和危重型组患者接受抗病毒治疗的药物种类、糖皮质激素、丙种球蛋白及鼻导管吸氧应用比例显著多于普通型组,差异有统计学意义(P <0. 05)。截至2月18日,1例危重型患者因合并急性大面积脑梗最终死亡,34例康复出院,其余患者仍在接受治疗。结论既往伴有多种心脑血管疾病的老年患者更易发生重型及危重型COVID-19,且常常合并多个器官或系统的异常,临床医师应根据临床症状、体征及实验室检查结果及时做出判断并调整治疗方案。Aim To analyze the clinical characteristics of patients of corona virus disease 2019(COVID-19),and summarize the treatment experience,aiming to provide diagnostic and treatment reference for the front-line clinicians.Methods Seventy-nine patients with COVID-19 admitted to the Infectious Hospital of Anhui Provincial Hospital from January 22 to February 18,2020 were selected as the research subjects.There were 55 cases in general group and 24 cases in severe and critical group.The clinical data of the two groups were collected and compared,including general conditions,clinical symptoms,signs,laboratory tests,computed tomography imaging of the lungs and complications.Results The average age of 79 COVID-19 patients was 45.1±16.6 years,and forty-five of them are males.The severe and critical group was older than the gen-eral group.Besides,there were more males and comorbidities.In terms of laboratory tests,the lymphocyte(LYM)count and albumin(ALB)decreased more significantly in the severe and critical groups.Moreover,the percentage of neutrophils(NEU),c-reactive protein(CRP),D-dimer,lactate dehydrogenase(LDH),troponin I(cTnI)and urea nitrogen(BUN)increased significantly.Among all the patients,the types of antiviral drugs in severe and critical group were significantly more than those in general group;moreover,the glucocorticoids,gamma globulin and oxygen inhalation by nasal catheter were used more frequently in severe and critical patients.By the time of February 18,one patient died of acute large area cerebral infarction,34 patients were discharged from hospital,and the rest were still receiving treatment.Conclusions The elderly patients with multiple cardiovascular diseases are more likely to get severe and critical COVID-19.They usually combine multiple organ or system abnormalities.Clinicians should make timely judgment and adjust the treatment plan according to the clinical symptoms,signs and laboratory examination results.

关 键 词：新型冠状病毒 新型冠状病毒肺炎 临床特征 洛匹那韦 干扰素 治疗 预后 

分 类 号：R373.1[医药卫生—病原生物学] R373.19[医药卫生—基础医学]