胸部CT特征预测普通型新型冠状病毒肺炎患者转归的价值  

Value of chest CT features in predicting the outcome of patients with common COVID-19

作　　者：刘长华[1] 余晓洁 杨先春[1] 左敏[1] 杨克勤[1] 杨帆[1] LIU Chang-hua;YU Xiao-jie;Yang Xian-chun(Department of Radiology,Hanyang Hospital Affiliated of Wuhan University of Science and Technology,Wuhan 430050,China)

机构地区：[1]武汉科技大学附属汉阳医院放射科,武汉430050

出　　处：《放射学实践》2020年第5期587-591,共5页Radiologic Practice

摘　　要：目的:探讨胸部CT特征评估普通型新型冠状病毒肺炎(COVID-19)患者转归情况的价值。方法:搜集入院时为普通型COVID-19的患者158例,根据入院后2~7天内是否发展为重症肺炎分为普通型组和转重症组;记录其临床资料、血清学指标以及胸部CT表现。利用多因素Logistic回归筛选普通型COVID-19转重症肺炎的独立影响因素。利用列线图预测普通型COVID-19患者的预后。结果:淋巴细胞计数减少(P=0.032)、病灶累及右肺中叶(P=0.020)、病灶累及肺叶数(P=0.021)以及病灶占整肺体积百分比(P=0.013)是影响普通型COVID-19转重症的独立影响因素。列线图模型拟合度为0.85,提示模型预测结果与实际一致性较好。结论:胸部CT的特征表现对普通型COVID-19患者临床分型的转变具有较好的预测能力,列线图可以方便地预测出每例普通型COVID-19患者转为重症肺炎的概率。Objective:To investigate the clinical value of chest CT features in evaluating the outcome of patients with common COVID-19.Methods:A total of 158 patients with common COVID-19 at the time of admission were collected and divided into the common type group and the severe type group according to whether they developed the severe pneumonia within 2~7 days after admission.The clinical data,serological indicators and chest CT findings were recorded.Multivariate logistic regression was used to screen the independent influencing factors of severe pneumonia developed from common COVID-19.A nomogram was used to predict the outcome of patients with common COVID-19.Results:Reduced lymphocyte count(P=0.032),involvement in the middle lobe of right lung(P=0.020),number of lung lobes involved(P=0.021),and percentage of lesions to the total lung volume(P=0.013)were independent factors influencing the progression to severe type COVID-19.The C-index of the nomogram model was 0.85,indicating that the predicted results of the model were in good agreement with the reality.Conclusion:The features of chest CT are useful to predict the outcome of patients with common COVID-19.The nomogram can easily predict the probability of each patient with common COVID-19 developing severe pneumonia.

关 键 词：新型冠状病毒肺炎 体层摄影术 X线计算机 临床分型 转归 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]