新型冠状病毒肺炎临床特征分析  

作　　者：沈月玉 王晓晗 韩丰[1] 肖琴锋 陈云清 冀子中[1] 

机构地区：[1]嘉兴学院附属第一医院,314000

出　　处：《浙江临床医学》2020年第7期984-986,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省嘉兴市抗击新冠肺炎疫情应急科技专项(2020GZ30001);嘉兴学院附属第一医院优秀青年基金(2018-GG-10)。

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)患者的临床特征,并分析重型新冠肺炎的危险因素.方法收集2020年1月至3月42例新冠肺炎患者临床相关数据,回顾性分析患者流行病学特征、发病症状、血液检验、影像学特点、治疗方案等.Logistic回归分析重型新冠肺炎的危险因素.结果42例患者中轻型3例,普通型27例,重型12例.有21例(50%)有湖北旅居史,14例(33.3%)有密切接触史,7例为家族聚集发病.临床症状表现以发热咳嗽为主,随着疾病分型加重,血常规中淋巴计数逐渐降低;超敏C反应蛋白、纤维蛋白原、天冬氨酸转氨酶、乳酸脱氢酶逐渐升高,白蛋白、前白蛋白逐渐减低,差异均有统计学意义.Logistic回归分析发现,糖尿病患者发生重症新冠肺炎的风险增加(OR=12.152,95%CI:1.487~99.275),入院时天冬氨酸转氨酶升高者发生重症新冠肺炎的风险增加(OR=1.163,95%CI:1.024~1.322).患有糖尿病及天冬氨酸转氨酶升高诊断重型新冠肺炎的AUROC分别为0.717、0.763.在疾病初期识别新冠肺炎,胸部CT检查较X线胸片检查更准确.所有患者经抗病毒等治疗均出院,无死亡病例.结论COVID-19发病最常见的症状是发热咳嗽,胸部CT有助于早期诊断,入院时天冬氨酸转氨酶水平、是否合并糖尿病可能有助于预测新冠肺炎的严重程度.Objective To analyze the clinical characteristics and risk factors of Novel coronavirus pneumonia(NCP)in Jiaxing.Methods The clinical data of 42 patients infected with 2019-nCov hospitalized in the first affiliated hospital ofjiaxing university on January 22,2020 were collected and analyzed.Logistic regression analysis of risk factors for severe NCP.Results Among the 42 patients,3 were light,27 were normal,and 12 were severe.There were 21 cases(50%)with a history of sojourn in Hubei province,14 cases(33.3%)with a history of close contact,and 7 cases with familial cluster.The clinical symptoms were mainly fever and cough.With the aggravation of the disease type,the blood routine lymphoid count gradually decreased.Hypersensitive c-reactive protein,fibrinogen,glutamate transaminase and lactate dehydrogenase gradually increased,while albumin and prealbumin,gradually decreased,and the differences were statistically significant.Logistic regression analysis found that patients with diabetes had an increased risk of severe NCP(OR=12.152,95%CI:1.487〜99.275),and those with elevated glutamate transaminase at admission had an increased risk of severe NCP(OR=1.163,95%CI:1.024-1.322),with statistically significant differences.The AUROC of diagnosis of severe NCP with diabetes and glutamate transaminase level were 0.717 and 0.763,respectively.Chest CT was more accurate than chest radiograph in identifying NCP at the early stage of the disease.All the patients were discharged after antiviral treatment,and there were no deaths.Conclusion The novel coronavirus pneumonia is the most common symptom of COVID-19.Fever and cough are the most common symptoms.Chest CT is helpful for early diagnosis.The level of aspartate aminotransferase and diabetes mellitus at admission are helpful to predict the severity of new crown pneumonia.

关 键 词：新型冠状病毒肺炎 临床特征 糖尿病 

分 类 号：R72[医药卫生—儿科]