武汉市金银潭医院305例不同发病时期新型冠状病毒肺炎患者临床特征分析  

Analysis of the Clinical Characteristics of 305 Patients with COVID-19 in Jinyintan Hospital of Wuhan City at Different Stage of the Epidemic

作　　者：黄汉平 许磊[2] 张丽 周霞 王剑文 邹鹏 余洋 罗珊珊 范陈戈 王菊莉 王融融 陶燕 周锋 HUANG Hanping;XU Lei;ZHANG Li;ZHOU Xia;WANG Jianwen;ZOU Peng;YU Yang;LUO Shanshan;FAN Chenge;WANG Juli;WANG Rongrong;TAO Yan;ZHOU Feng(Department of Tuberculosis,Jinyintan Hospital of Wuhan City,Wuhan 430023,China;Department of Emergency,Gongli Hospital of Pudong New Area,Shanghai City,Shanghai 200135,China;People’s Hospital of Zhujiajiao,Shanghai City,Shanghai 201713,China;Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700,China;Department of Nursing,Pulmonary Hospital of Pudong New Area,Shanghai City,Shanghai 201209,China)

机构地区：[1]武汉市金银潭医院结核科,武汉430023 [2]上海市浦东新区公利医院急诊科,上海200135 [3]上海市朱家角人民医院,上海201713 [4]复旦大学附属中山医院青浦分院,上海201700 [5]上海市浦东新区肺科医院护理部,上海201209

出　　处：《医药导报》2020年第6期797-802,共6页Herald of Medicine

基　　金：上海市青浦区科学技术委员会科技发展基金项目(QKY2018-12)。

摘　　要：目的分析305例不同发病时期的新型冠状病毒肺炎患者临床特征及流行病学特征,研究临床特征和流行病学特征的时间规律,为新型冠状病毒肺炎的控制和患者救治提供参考。方法回顾性分析2019年12月-2020年2月在武汉市金银潭医院收治入院的新型冠状病毒肺炎患者305例。按患者发病时间将研究对象分为A、B、C、D四组,A组:2019年12月31日前发病,共72例;B组:2020年1月1-14日间发病,共72例;C组:2020年1月15-28日间发病,共84例;D组2020年1月29日-2月11日间发病,共77例。比较分析四组患者性别、年龄、发病到住院间隔时长、住院天数、临床症状、影像学特征、既往疾病史、接触史、入院后治疗情况和疾病转归。结果 A组到D组,患者平均年龄呈增长趋势,差异有统计学意义(F=12.62,P<0.000 1)。四组患者组间家庭接触史构成比差异有统计学意义(χ~2=12.051,P=0.007)。各组发热天数的中位数差异有统计学意义(H=43.88,P<0.01)。四组患者使用糖皮质激素、丙种球蛋白、抗真菌治疗和抗病毒治疗的比例不同,组间差异有统计学意义(χ~2=23.78,P<0.000 18;χ~2=33.07,P<0.000 1;χ~2=21.52,P<0.000 1;χ~2=60.634,P<0.000 1)。四组患者组间中位住院时间差异有统计学意义(χ~2=21.383,P<0.000 1)。影像学表现四组整体比较,差异有统计学意义(χ~2=38.43,P<0.000 1)。结论新型冠状病毒肺炎疫情随着政策干预、感染防护措施加强、医疗救治力量加强、医疗诊治方案完善,其病情表现呈现在时间维度上由发展到峰值到逐渐好转下降的规律特点。Objective To analyze the patterns of the clinical and epidemiologic features of 305 patients with COVID-19 at different stage of the epidemic to provide reference for the control of COVID-19 and the treatment of patients.Methods A total of 305 patients with COVID-19 admitted to Jinyintan hospital of Wuhan City from December 2019 to February 2020 were enrolled.According to the onset time of disease,the subjects were divided into four groups:A,B,C and D.In group A,there were 72 patients who were onset before December 31,2019;In group B,there were 72 patients who were onset from January 1,2020 to January 14,2020.In group C,there were 84 patients who were onset from January 15 to January 28,2020.In group D,there were 77 patients who were onset from January 29 to February 11,2020.The gender,age,the time length of onset of disease,hospitalization days,clinical symptoms,imaging characteristics,previous disease history,exposure history,treatment status and disease prognosis after admission among four groups of patients were compared and analyzed.Results The average age of patients showed an increasing trend,and the difference was significant(F=12.62,P<0.0001).The difference of family exposure history among the four groups was statistically significant(χ2=12.051,P=0.007).The median number of fever days in each group was statistically significant(H=43.88,P<0.01).The proportion of the four groups of patients receiving corticosteroids,gamma globulin,antifungal and antiviral therapy was different,and the difference among the four groups was statistically significant(χ2=23.78,P<0.00018;χ2=33.07,P<0.0001;χ2=21.52,P<0.0001;χ2=60.634,P<0.0001).The overall comparison of the imaging presentation among the four groups showed statistical differences(χ2=38.43,P<0.0001).Conclusion The characteristics of patients with COVID-19 showed a first increased and then decreased trend,which may because of the policy intervention,strengthening of protective measures and health care force,and improvements of treatment plan.

关 键 词：新型冠状病毒肺炎 COVID-19 不同发病时间 临床特征 

分 类 号：R511[医药卫生—内科学]