河北省新型冠状病毒肺炎病例临床与流行病学特征分析  

Analysis of the epidemiological characteristics and clinical features of COVID-19 in Hebei Province

作　　者：晁灵善[1] 蔡志刚[1] 吕建波[2] 胡振杰[3] 耿立梅[4] 王新举[5] 孙武装[6] 陈分乔[7] 阎锡新[1] Chao Lingshan;Cai Zhigang;Lyu Jianbo;Hu Zhenjie;Geng Limei;Wang Xinju;Sun Wuzhuang;Chen Fenqiao;Yan Xixin(Department of Pulmonary and Critical Care Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang 050000,China;Department of Intensive Care Unit,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Respiratory Medicine,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;Department of Radiology,Hebei Provincial Chest Hospital,Shijiazhuang 050000,China;Department of Pulmonary and Critical Care Medicine,the First Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Emergency,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院呼吸与危重症医学一科,石家庄050000 [2]河北省疾病预防控制中心,石家庄050000 [3]河北医科大学第四医院重症医学科,石家庄050000 [4]河北省中医院呼吸一科,石家庄050000 [5]河北省胸科医院放射科,石家庄050000 [6]河北医科大学第一医院呼吸与危重症医学科,石家庄050000 [7]河北省中医院急诊科,石家庄050000

出　　处：《国际呼吸杂志》2020年第13期961-965,共5页International Journal of Respiration

基　　金：河北省重点研发计划(20277701D)。

摘　　要：目的分析河北省新型冠状病毒肺炎(COVID-19)病例临床与流行病学特征,为河北省疫情防控提供数据支持。方法收集2020年1月22日至3月3日河北省所有COVID-19确诊病例临床资料,回顾性的分析患者流行病学史与临床特征。结果本研究共收集到河北省11地市317例确诊COVID-19病例,轻型+普通型、重型、危重型病例分别为270例(85.2%)、28例(8.8%)、19例(6.0%),其中309例康复出院,6例死亡,2例仍在继续治疗中。男170例(53.6%),110例(34.7%)的患者最少合并1种基础病。最常见的症状是发热(69.7%),而呼吸困难(6.3%)、腹泻(8.7%)和恶心呕吐(3.9%)相对少见。2月6日前230例发病,其中73例(31.7%)为发病前14 d有武汉旅行或居住史。3组淋巴细胞计数比较,差异有统计学意义(H=17.774,P<0.001)。重型、危重型患者乳酸脱氢酶、C-反应蛋白、D-二聚体水平较轻型+普通型高(P值均<0.001)。结论来自疫区的COVID-19感染者多数会在2周内发病,因此严格的2周隔离至关重要。COVID-19患者年龄≥60岁合并基础病,外周血淋巴细胞计数下降,乳酸脱氢酶、C-反应蛋白、D-二聚体明显升高时,进展至重型与危重型可能性大。Objective To investigate the epidemiological characteristics and clinical features of COVID-19 in Hebei Province,China and offer data support for the control of the epidemic and disease management.Methods Retrospectively analyzed all confirmed COVID-19 cases in Hebei Province from January 22nd,2020 to March 3rd,2020 to investigate the epidemiological characteristics and clinical features.Results A total of 317 confirmed cases of COVID-19 patients in 11 cities of Hebei Province were collected.309 patients made full recovery,six cases critically ill patients died,and two cases are still receiving treatment.170 cases(53.6%)are males,110 cases(34.7%)had at least one comorbidity.The proportions of mild/moderate,severe,and critical cases out of total cases are 85.2%(n=270),8.8%(n=28),6.0%(n=19),respectively.The most common symptoms was fever(69.7%).Dyspnoea(6.3%),diarrhea(6.6%)and nausea/vomiting(3.8%)were relatively uncommon.230 cases developed symptoms before February 6th,and 73 cases(31.7%)had a history of travel or residence in Wuhan within 14 days before the onset of illness.Lymphopenia has been found in 52(20.2%)mild/moderate cases,11(64.7%)severe cases,and 11(61.1%)critical cases.The levels of LDH,C-Reactive Protein,and D-dimer in severe and critical cases were higher than those of mild/moderate cases.Conclusions People who infected from epidemic area are most likely to present with symptoms within 14 days,thus making the 2-week quarantine crucial.Patients over 60 years of age with underlying disease,and patients with decreased peripheral blood lymphocyte count or significantly elevated CRP,LDH,and D-dimer levels are more likely to progress to severe or critical condition.They are more likely progress to severe or critical type.

关 键 词：新型冠状病毒肺炎 严重急性呼吸综合征冠状病毒2 淋巴细胞减少 

分 类 号：R563.1[医药卫生—呼吸系统] R181.3[医药卫生—内科学]