广东省肇庆地区19例新型冠状病毒肺炎确诊病例临床特征分析  

Clinical characteristics of 19 COVID-19 confirmed cases in Zhaoqing,Guangdong

作　　者：梁丽霞[1] 陈世准[2] 程慧 张燕霞 刘健[1] 陈平[1] LIANG Lixia;CHEN Shizhun;CHENG Hui;ZHANG Yanxia;LIU Jian;CHEN Ping(Clinical Laboratory.The first People’s Hospital of Zhaoqing,Zhaoqing 526060,China;Infectious diseases department.The first People’s Hospital of Zhaoqing,Zhaoqing 526060,China;CT Room.The first People’s Hospital of Zhaoqing,Zhaoqing 526060,China;Clinical Laboratory,The People’s Hospital of Fengkai county,Zhaoqing 526500,China.)

机构地区：[1]广东省肇庆市第一人民医院检验科,肇庆526060 [2]广东省肇庆市第一人民医院感染性疾病科,肇庆526060 [3]广东省肇庆市第一人民医院CT室,肇庆526060 [4]广东省肇庆市封开县人民医院检验科,肇庆526500

出　　处：《江西医药》2020年第8期979-983,1004,共6页Jiangxi Medical Journal

摘　　要：目的分析肇庆地区19例新型冠状病毒肺炎确诊病例临床特征,为临床诊断提供参考数据。方法收集2020年1月22日-3月6日19例来源于肇庆市第一人民医院和封开县人民医院新型冠状病毒确诊病例患者的临床资料及实验室检查结果,采用SPSS 19.0软件进行统计分析。结果19例COVID-19确诊病例男性患者比女性患者多,感染年龄介于3岁到65岁之间,重型患者及死亡患者年龄在56-64岁之间,无地区特异性分布。临床分型轻型(10.5%)、普通型(73.7%)、重型(10.5%)、死亡(5.3%)。临床症状表现为发热(94.7%)、乏力(68.4%)、咳嗽(57.9%)为主,还有气促、流涕、鼻塞、咽痛、咽痒、腹泻等症状。住院天数为8-33d,出院后复阳率为21.1%。83.3%患者CT表现为单肺或双肺不同程度的肺炎病灶,重型CT表现为双肺多发磨玻璃样病变。A型血型患者(52.6%)比B型(26.3%)、O型(21.1%)患者多,重型和死亡病例血型均为B型。入院血常规,WBC和LY#大多病例正常,极少数偏低或偏高,血清CRP(57.9%)、ESR(89.5%)升高,部分患者FIB(42.1%)、ALT(21.1%)、LDH-L(42.1%)和HBDH(37.5%)轻度升高,普通组和重症组的HBDH两组比较有显著性差异(P<0.05),其余项目两组比较均无显著性差异(P>0.05)。患者9.5%合并嗜肺军团菌感染,4.8%合并肺炎衣原体或肺炎支原体感染。鼻咽拭子RNA阳性检出率(63.1%)最高,其次是肛拭子(24.3%),口咽拭子(7.7%),痰(4.9%)。鼻咽拭子和肛拭子Ct值比较,N基因Ct值无显著性差异(P>0.05),而ORF1ab基因Ct值差别有显著性差异(P<0.05)。结论重型COVID-19患者大多是老年人,部分具有基础疾病,出现了肺部、心肌损伤等炎症反应,临床医师可根据临床症状、实验室检测指标和胸部影像学CT表现及时做出诊断并合理治疗。Objective Clinical characteristics of 19 COVID-19 cases in Zhaoqing area,to peovide reference data for clinical.Method Collected Clinical data and laboratory results of 19 patients with COVID-19 come from Zhaoqing and Fengkai Country People’s Hospital on January 22 to March 6,2020,Statistical analysis by SPSS 19.0.Result There are more male patients than female patients in 19 cases of COVID-19,The age of infection was between 3 and 65 years old,no regional specific distribution.19 cases of COVID-19 were classified as light(10.5%),common(73.7%),severe(10.5%),and death(5.3%).The main clinical symptoms are fever(94.7%),fatigue(68.4%),cough(57.9%),and shortness of breath,runny nose,stuffy nose,sore throat,itchy throat,diarrhea,etc.Those patients’s hospital stay were 8-33 days,The recovery rate after discharge was 21.1%.CT findings of 83.3%patients were single lung or double lung with varying degrees of pneumonia,Severe CT showed multiple ground glass lesions in both lungs.52.6%of patients with type A blood group were more than type B(26.3%),type O(21.1%)blood group,the blood type of severe cases and death cases were all type B.Most cases of WBC and LY#were normal,few were low or high,Serum CRP(57.9%)and ESR(89.5%)were increased,FIB(42.1%),ALT(21.1%),LDH-L(42.1%)and HBDH(37.5%)were slightly increased in some patients.There was significant difference in HBDH between the common group and the severe group(P<0.05).There was no significant difference with the other between two groups(P>0.05).9.5%of the patients had Legionella pneumophila infection,4.8%had Chlamydia pneumoniae or Mycoplasma pneumoniae infection.The highest positive rate of RNA was found in nasopharyngeal swab(63.1%),followed by anal swab(24.3%),oral swab(7.7%),sputum(4.9%).There was no significant difference in Ct value of N gene between nasopharyngeal swab and anal swab(P>0.05),but significant difference in Ct value of ORF1ab gene(P<0.05).Conclusion Most of the patients with severe COVID-19 are old people,some of them have basic diseases,there are infl

关 键 词：新型冠状病毒 新型冠状病毒肺炎 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]