新型冠状病毒肺炎重症患者相关危险因素多中心临床研究  

Multi-Center Clinical Research of Risk Factors Associated with Severe and Critical Patients with Coronavirus Disease 2019

作　　者：李若青 陶静[1] 姚小红 杨芳[3] 彭鹏[1] 唐军[1] 李宝善 刘凤琼 LI Ruoqing;TAO Jing;YAO Xiaohong;YANG Fang;PENG Peng;TANG Jun;LI Baoshan;LIU Fengqiong(Chongqing University Central Hospital,Chongqing Emergency Medical Center,Chongqing,China 400014;Dawu Hospital of Traditional Chinese Medicine,Xiaogan,Hubei,China 432800;Hanchuan City People's Hospital,Xiaogan,Hubei,China 431600;Changshou District Hospital of Traditional Chinese Medicine,Chongqing,China 401220)

机构地区：[1]重庆大学附属中心医院·重庆市急救医疗中心,重庆400014 [2]湖北省孝感市大悟县中医医院,湖北孝感432800 [3]湖北省汉川市人民医院,湖北孝感431600 [4]重庆市长寿区中医院,重庆401220

出　　处：《中国药业》2020年第9期15-18,共4页China Pharmaceuticals

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)患者的临床特征、危险因素,为COVID-19的诊治提供参考。方法选取2020年1月21日至3月2日大悟县中医院和汉川市人民医院感染科收治的COVID-19患者193例,其中普通型组122例,重型和危重型(重症)组71例。比较两组患者的临床资料,包括一般情况、临床症状、实验室检查等,回顾性分析重症患者的危险因素。结果193例患者中,男112例,女81例;平均年龄为(50.7±16.2)岁。重症组患者的发病年龄更大,且有更多的高血压、糖尿病合并症;白细胞(WBC)及中性粒细胞(NEU)计数、C反应蛋白(CRP)、D-二聚体(D-D)、血肌酐(SCr)、尿素氮(BUN)较普通型组明显升高,淋巴细胞(LYM)计数、白蛋白(ALB)明显降低,差异均有统计学意义(P<0.05)。多因素Logistic回归分析提示,高血压、糖尿病、年龄、WBC和LYM降低,与COVID-19重型及危重型存在相关性。结论伴有高血压、糖尿病、淋巴细胞降低、老年患者更易发生重型及危重型COVID-19,临床应根据临床症状、实验室检查结果及时评估病情,控制基础疾病,警惕普通型进展成重型及危重型。Objective To analyze the clinical characteristics and risk factors of patients with coronavirus disease 2019(COVID-19),and to provide reference for the diagnosis and treatment of COVID-19.Methods From January 21st to March 2nd,2020,193 patients with COVID-19 admitted to the infection department of Dawu Hospital of Traditional Chinese Medicine and Hanchuan City People's Hospital were selected,including 122 cases in the general group and 71 cases in the severe and critical group.The clinical data of patients in the two groups were collected and compared,including general conditions,clinical symptoms,laboratory tests,etc.,a nd the risk factors of severe and critical patients were analyzed retrospectively.Results Among the 193 patients,112 patients were male and 81 patients were female,with an average age of(50.7±16.2)years old.The age of onset of patients in the severe and critical groups was older than that in the general group,with more hypertension and diabetes co-existing diseases.The white blood cell(WBC)and neutrophils(NEU)counts,C-reactive protein(CRP),D-dimer(D-D),serum creatinine(SCr)and blood urea nitrogen(BUN)of the patients in the severe and critical groups were significantly higher than those in the general group,while the lymphocyte(LYM)counts and albumin(ALB)in the severe and critical groups were significantly lower than those in the general group,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis suggested that the decrease of hypertension,diabetes,age,WBC and LYM was correlated with the severe and critical COVID-19.Conclusion Patients with hypertension,diabetes and lymphocytopenia are more likely to develop severe and critical COVID-19.Clinicians should timely assess the condition according to clinical symptoms and laboratory examination results,control co-existing diseases,and guard against common type becoming severe and critical type.

关 键 词：新型冠状病毒肺炎 淋巴细胞 临床特征 危险因素 多中心临床研究 

分 类 号：R95[医药卫生—药学] R184