不同临床分型新型冠状病毒肺炎患者实验室检查结果的特点分析  

The Characteristics of Laboratory Results of Different Types of COVID-19 Patients

作　　者：倪明[1] 韩梅芳[1] 孟凡凯[2] 周莹[3] 陈蕾[3] 赵建平[3] Ni Ming;Han Meifang;Meng Fankai(Department of Infectious Diseases,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Hematology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院感染科,武汉430030 [2]华中科技大学同济医学院附属同济医院血液科,武汉430030 [3]华中科技大学同济医学院附属同济医院呼吸内科,武汉430030

出　　处：《华中科技大学学报（医学版）》2020年第2期189-193,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的 比较不同临床分型的新型冠状病毒肺炎患者实验室检查结果与病情严重程度的相关性.方法 以2020年2月1日至2020年2月21日在华中科技大学同济医学院附属同济医院发热病房住院的50例确诊新型冠状病毒肺炎患者为研究对象,根据国家卫生健康委员会的诊断标准,该50例患者被分为危重型(8例)、重型(32例)、普通型(10例),比较不同型别患者的血常规、血生化、凝血常规结果和炎症因子的表达水平,分析上述指标的变化规律及其与临床分型的关系.结果 危重型患者白细胞和中性粒细胞计数明显高于重型和普通型患者(P<0.05);危重型和重型患者淋巴细胞计数下降较普通型患者更明显(P<0.05);危重型患者较重型和普通型患者乳酸脱氢酶水平升高,肾功能损害、凝血功能异常更明显(均P<0.05);危重型患者的降钙素原、超敏C反应蛋白、IL-6和TNF-α水平升高较重型和普通型患者更明显(均P<0.05);超敏C反应蛋白水平在重型和普通型患者之间的差异也具有统计学意义(P<0.05).结论 危重型新型冠状病毒肺炎患者更易合并细菌感染和多器官功能损害;超敏C反应蛋白、IL-6、TNF-α表达水平可灵敏反映患者全身炎症反应程度,有助于疾病临床分型.Objective To compare the correlation between laboratory results and the severity of disease in COVID-19 patients with different clinical types.Methods Fifty patients diagnosed with COVID-19 admitted to the Fever Ward of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from February 1,2020 to February 21,2020 were taken as research objects.The 50 patients were classified as critical(8 cases),severe(32 cases),and mild type(10 cases)according to the standard of"Diagnosis and treatment program of new coronavirus pneumonia(trial version 7)"of National Health Commission of China.The results of blood routine test,blood biochemical test and coagulation routine test,and inflammatory factor expression levels were compared between different types of patients.The changes of these indicators and their relationship with clinical classification were analyzed.Results Significantly more white blood cells and neutrophils were found in critical patients than in severe and mild patients(P<0.05).Lymphocytes were decreased significantly in critical and severe patients than in mild patients(P<0.05).The elevation of lactate dehydrogenase,impaired renal function,and abnormal blood coagulation were more significantly in the critical patients than in severe and mild patients(P<0.05).The levels of procalcitonin,high-sensitivity C-reactive protein,IL-6 and TNF-αwere significantly higher in critical patients than in severe and mild patients(P<0.05).The difference in the high-sensitivity C-reactive protein between severe and mild patients was also significant(P<0.05).Conclusion Critical COVID-19 patients are more likely to be complicated by bacterial infection and multiple organ dysfunction.The levels of high-sensitivity C-reactive protein,IL-6 and TNF-αcan sensitively reflect patients’systemic inflammation and contribute to the clinical typing of COVID-19.

关 键 词：新型冠状病毒肺炎 临床分型 实验室检查 

分 类 号：R512.99[医药卫生—内科学]