武汉市金银潭医院112例合并不同基础疾病新型冠状病毒肺炎患者临床特征分析  

Analysis of the Clinical Characteristics of 112 Cases of COVID-19 Patients with Underlying Diseases in Jinyintan Hospital of Wuhan City

作　　者：徐杰 施国华 周锋 王剑文 许磊[5] 鲁立文 林小芹 陶燕 翟晓惠 蔡海英 谢邦瓀 黄汉平 XU Jie;SHI Guohua;ZHOU Feng;WANG Jianwen;XU Lei;LU Liwen;LIN Xiaoqin;TAO Yan;ZHAI Xiaohui;CAI Haiying;XIE Bangru;HUANG Hanping(Department of Internal Medicine,Guhua Hospital,Fengxian District,Shanghai City,Shanghai 201499,China;Department of Internal Medicine,Chinese Traditional Hospital of Qingpu District,Shanghai City,Shanghai 201700,China;Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700,China;Jinyintan Hospital of Wuhan City,Wuhan 430023,China;Gongli Hospital of Pudong New Area,Shanghai City,Shanghai 200135,China;Department of Respiratory Medicine,Central Hospital of Fengxian District,Shanghai City,Shanghai 201499,China;Pulmonary Hospital of Pudong New Area,Shanghai City,Shanghai 201209,China;Department of Respiratory Medicine,Fengcheng Hospital of Fengxian District,Shanghai City,Shanghai 201411,China)

机构地区：[1]上海市奉贤区古华医院内科,上海201499 [2]上海市青浦区中医院内科,上海201700 [3]上海复旦大学附属中山医院青浦分院,上海201700 [4]武汉市金银潭医院,武汉430023 [5]上海市浦东新区公利医院,上海200135 [6]上海市奉贤区中心医院呼吸内科,上海201499 [7]上海市浦东新区肺科医院,上海201209 [8]上海市奉贤区奉城医院呼吸科,上海201411

出　　处：《医药导报》2020年第6期806-810,共5页Herald of Medicine

摘　　要：目的分析合并基础疾病新型冠状病毒肺炎(新冠肺炎)患者的临床特征,探讨其危险因素,为新冠肺炎的控制和救治提供参考。方法收集武汉市金银潭医院于2019年12月30日-2020年3月8日收治306例新冠肺炎患者资料,以无基础疾病的患者为对照,分析112例合并有基础疾病患者的临床症状、实验室检查、影像学资料、治疗及转归情况。结果两组患者年龄、性别、住院时间,组间比较差异无统计学意义。基础疾病组发热发生率78.57%,较无基础疾病组低(P=0.012),咳嗽发生率较高(P=0.025),胸闷、气促症状发生率较高(P=0.007),基础疾病组肺炎累及肺部影像学范围>75%的患者比例高(P=0.015)。与无基础疾病组比较,基础疾病组普通型患者比例较低(P<0.001);危重型患者比例高(P=0.013)。两组使用糖皮质激素,丙种球蛋白和抗真菌治疗差异无统计学意义。与无基础疾病组比较,基础疾病组出院肺功能恢复正常状态患者比例低(P<0.000 1),出院但肺功能未恢复正常状态比例高(P<0.000 1)。结论合并基础疾病的新冠肺炎患者,发热比例较无基础疾病的新冠肺炎患者低,但咳嗽、胸闷、气促症状比例增高,病情发展快,侵犯肺部范围大、危重症率高、预后较差,通过合理治疗,可以降低死亡率、提高治愈率。Objective To analyze the clinical characteristics of COVID-19 patients with underlying diseases and to explore risk factors in order to provide reference for the control of COVID-19 and the treatment of patients.Methods A total of 306 cases of COVID-19 patients,who were admitted to Jinyintan hospital of Wuhan from December 30,2019 to March 8,2020 were collected,and the treatment and outcome of 112 cases of patients with clinical symptoms,laboratory examination and imaging data of patients with underlying diseases were analyzed by taking patients without underlying diseases as control.Results There was no statistically significant difference between the two groups in terms of age,gender and hospitalization time.The incidence of fever in the group with underlying disease was 78.57%,which is lower than the group without underlying disease(P=0.012).Compared with the group without underlying disease,the incidence of cough in the group with underlying disease was higher(P=0.025),the incidence of symptoms of chest distress was higher(P=0.007),the cases of pneumonia involving more than 75%of the pulmonary imaging range was higher(P=0.015).Compared with the group without underlying disease,the proportion of ordinary patients(P<0.001),and the proportion of critical severe patients(P=0.013)in the underlying disease group were lower.There was no statistically significant difference between the groups treated with corticosteroids,gamma globulin and antifungal therapy.Compared with the group without underlying disease,The proportion of patients discharged from hospital and returned to normal activity was lower in the group without underlying disease(P<0.0001),The proportion of patients in the underlying disease group who were discharged but did not return to normal activity was higher(P<0.0001).Conclusion The proportion of fever in COVID-19 patients with underlying diseases was lower than that of COVID-19 patients without underlying diseases,but the proportion of cough,chest tightness,shortness of breath symptoms was increased

关 键 词：新型冠状病毒肺炎 基础疾病 临床特征 危险因素 

分 类 号：R511[医药卫生—内科学]