宁夏回族自治区新型冠状病毒肺炎34例患者临床特征分析  

The analysis of clinical characteristics of 34 novel coronavirus pneumonia cases in Ningxia Hui autonomous region

作　　者：张淑香[1] 李静 周攀 纳建荣[1] 刘伯飞 郑西卫[1] 曹相原[5] 童安荣 高晓芳 王晓麒[5] 谢峰[8] 徐麟 马国仁 周玮[1] Zhang Shuxiang;Li Jing;Zhou Pan;Na Jianrong;Liu Bofei;Zheng Xiwei;Cao Xiangyuan;Tong Anrong;Gao Xiaofang;Wang Xiaoqi;Xie Feng;Xu Lin;Ma Guoren;Zhou Wei;无(Department of Respiratory and Critical Care Medicine,The General Hospital of Ningxia Medical University,Yinchuan,750004,China;Department of Internal Medicine,The Fourth People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,750021,China;Department of Radiology,The Fourth People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,750021,China;Intensive Care Unit,The Fourth People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,750021,China;Intensive Care Unit,General Hospital of Ningxia Medical University,Yinchuan,750004,China;Department of traditional Chinese medicine,Ningxia Institute of traditional Chinese medicine,Yinchuan,750021,China;Intensive Care Unit,The First People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,750004,China;Department of Pediatrics,General Hospital of Ningxia Medical University,Yinchuan,750004,China;Department of Respiratory,The Fourth People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,750021,China)

机构地区：[1]宁夏医科大学总医院呼吸与危重症医学科,银川750004 [2]宁夏第四人民医院内科,银川750021 [3]宁夏第四人民医院放射科,银川750021 [4]宁夏第四人民医院重症医学科,银川750021 [5]宁夏医科大学总医院重症医学科,银川750004 [6]宁夏中医研究院中医内科,银川750021 [7]宁夏第一人民医院重症医学科,银川750004 [8]宁夏医科大学总医院儿科,银川750004 [9]宁夏第四人民医院呼吸内科,银川750021

出　　处：《中华结核和呼吸杂志》2020年第5期431-436,共6页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：2020年宁夏回族自治区重点研发计划科技支撑专项(2020BEG003004)。

摘　　要：目的分析34例2019新型冠状病毒肺炎(COVID-19)患者的临床特征。方法采用单中心回顾性研究方法,纳入2020年1月22日至2月4日宁夏回族自治区第四人民医院(传染病医院)隔离病房集中收治的34例COVID-19患者,其中男20例,女14例,年龄10~77岁,平均(41±17)岁,收集患者临床资料。记录临床分型与年龄分布的关系及研究对象接触史与发病日期,使用SPSS 25.0统计软件进行处理,分析其流行病学、临床和肺影像学特征及实验室数据、治疗及预后。结果本组患者轻型5例(5/34)、普通型24例(24/34)、重型5例(5/34),重型患者以老年多见。主要临床症状为发热(27/34),干咳(26/34);外周血一般表现为白细胞总数正常或减低(33/34),淋巴细胞计数减少(12/34),C反应蛋白和D-二聚体的增高和病情的严重程度相关。个别患者存在轻度肝肾功能损害。6例患者第3次或第3次以上核酸检测阳性才得以确诊。武汉居住或逗留后发病16例(第1代),与第1代发病患者接触发病11例(第2代),与第二代患病者接触发病2例(第3代),无任何接触史者5例。6个家庭聚集发病。典型病例的CT表现为单发或多发的斑片状磨玻璃影,伴有小叶间隔增厚;重症患者表现为双肺弥漫性病变,磨玻璃影、实变影、条索影共存。治疗以α-干扰素雾化吸入、洛匹那韦/利托那韦抗病毒治疗为主,34例患者均预后良好。结论COVID-19的临床特征与一般病毒性肺炎类似,但传染性强,密切接触及家庭聚集可能造成疾病传播;两次核酸检测阴性不能排除,高分辨率CT有助于鉴别诊断;早发现,早隔离、早诊断、早治疗,预后良好。抗病毒药物的有效性需要进一步验证。Objective To analyze the clinical characteristics of 34 COVID-19 cases and to provide the basis for the prevention and control of the epidemic disease.Methods Thirty-four COVID-19 patients diagnosed with RT-PCR in the isolation ward of the Fourth People′s Hospital of Ningxia Hui autonomous region(infectious diseases hospital)from the January 22 to February 4,2020 were selected as the research subjects.The clinical data were collected.Excel was used to describe the relationship between clinical classification and age distribution,contact history and date of onset.SPSS 25.0 statistical software was used for analysis.The general information,clinical symptoms,blood test,virus nucleic acid test results,epidemiology,CT imaging,treatment and prognosis were analyzed.Results There were 5 mild cases(5/34),24 ordinary cases(24/34),5 severe cases(5/34).The elderly was more common in severe patients.The main clinical symptoms were fever(27/34)and dry cough(26/34).The peripheral blood showed normal or decreased leukocyte count(33/34),decreased lymphocyte count(12/34).The increase of C-reactive protein(CRP)and D-dimer was related to the severity of the disease.Some patients had mild liver and kidney damage.Six patients were diagnosed through 3 or more times of nucleic acid tests.Sixteen cases had Wuhan related history,13 cases were close contacts,5 cases had no confirmed route.The clustered infections were found in 6 families.In typical cases,CT showed single or multiple patchy ground glass shadow with thickening of interlobular septum.In severe cases,diffuse lesions of both lungs were found,with ground glass shadow,consolidation shadow and strip shadow coexisting.Thirty-four patients were treated with interferon-αand Lopinavir/Ritonavir with good prognosis.Conclusions The clinical characteristics of COVID-19 were similar to that of general viral pneumonia but with strong infectivity.Close contact and family aggregation caused disease outbreaks.COVID-19 could not be excluded if two nucleic acid tests were negative and high-r

关 键 词：新型冠状病毒 新型冠状病毒肺炎 临床特征 

分 类 号：R563[医药卫生—呼吸系统]