南京地区91例新型冠状病毒肺炎患者首次入院相关实验室检查结果分析  

Analysis of related laboratory examination results of 91 patients with coronavirus disease 2019 at first admission in Nanjing area

作　　者：蔡兴龙 刘璇[1] 黄玲[1] 张永臣 CAI Xinglong;LIU Xuan;HUANG Ling;ZHANG Yongchen(Department of Clinical Laboratory,the Second Hospital of Nanjing,Nanjing Public Health Medical Center,Nanjing 210003,China)

机构地区：[1]南京市第二医院(南京市公共卫生医疗中心)检验检测中心,江苏南京210003

出　　处：《南京医科大学学报（自然科学版）》2020年第4期478-484,共7页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:回顾性分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者首次入院的相关实验室指标变化,为临床早期诊治提供实验室参考依据。方法:选取和分析南京市公共卫生医疗中心收治的91例COVID-19患者首次入院时实验室检查指标,包括血液常规、生化指标、炎症标志物、凝血功能和淋巴细胞亚群计数等的分布情况。结果:血液常规检查中部分患者出现白细胞总数和淋巴细胞计数降低,降低患者占比分别为21.98%和17.58%。生化指标检查中丙氨酸氨基转移酶、天门冬氨酸氨基转移酶和乳酸脱氢酶升高的比例分别为13.19%、14.29%和36.67%,在心肌酶检查中磷酸肌酸激酶升高的比例为18.37%(男)、9.75%(女),磷酸肌酸激酶同工酶、肌红蛋白和肌钙蛋白Ⅰ升高的比例分别为5.68%、6.82%和19.32%。炎症指标检查中降钙素原水平整体变化不大,C-反应蛋白水平升高。凝血功能和纤溶检测中各指标无明显异常。淋巴细胞亚群检测发现CD3^+T、CD4^+T、CD8^+T、CD16/56^+NK细胞和CD19^+B细胞结果正常比例分别为62.07%、60.92%、65.51%、73.26%和95.35%,降低比例分别为32.18%、34.48%、27.59%、24.42%和4.65%。结论:COVID-19患者首次入院部分实验室指标出现特征性改变,可供临床初步判断,综合评估患者全身情况,结合核酸检测可提供重要参考依据。Objective:To retrospectively analyze the changes of related laboratory indexes at first admission in patients with coronavirus disease 2019(COVID-19),so as to provide laboratory reference for early clinical diagnosis and treatment. Methods:The laboratory examination indexes,including blood routine,biochemical indexes,inflammatory markers,coagulation function,and lymphocyte subsets count were selected and analyzed at first admission in 91 patients with COVID-19 and admitted to Nanjing Public Health Medical Center. Results:The total white blood cells and the lymphocytes counts in the routine blood examination were decreased in 21.98% and 17.58% of patients,respectively. In biochemical indexes,ALT,AST,and LDH were elevated in 13.19%,14.29%,and 36.67% of patients,respectively;the proportions of patients with elevated phosphocreatine kinase in myocardial enzyme examination were 18.37% in male and 9.75% in female,and creatine kinase isoenzyme,myoglobin,and troponin Ⅰ were elevated in 5.68%,6.82%,and19.32% of patients,respectively. The level of inflammatory index procalcitonin was generally normal,while the level of C-reactive protein was increased. There were no obvious abnormalities in the indexes of coagulation function and fibrinolysis. The proportions of patients with normal CD3^+T,CD4^+T,CD8^+T,CD16/56^+NK cells,and CD19^+B cells were 62.07%,60.92%,65.51%,73.26%,and 95.35%,respectively,and reduced in 32.18%,34.48%,27.59%,24.42%,and 4.65% of patients,respectively. Conclusion:Some laboratory indexes of patients with COVID-19 showed characteristic changes at first admission,which can provide preliminary clinical judgment,comprehensive assessment of the patient’s condition,and provide important reference based on nucleic acid detection.

关 键 词：新型冠状病毒肺炎 实验室指标 白细胞 淋巴细胞 

分 类 号：R563.1[医药卫生—呼吸系统]