山西省入住ICU新型冠状病毒肺炎患者临床特征分析  

Clinical features of patients with new coronavirus pneumonia admitted to ICU in Shanxi province

作　　者：段燕[1] 蒋蕊[2] 康玮霞 赵爱斌[3] 黄明光[1] DUAN Yan;JIANG Rui;KANG Weixia;ZHAO Aibin;HUANG Mingguang(Department of Intensive Medicine,Shanxi Provincial Cancer Hospital,Taiyuan 030001,China;Department of Respiratory and Critical Care Medicine,Shanxi Provincial People’s Hospital;Department of Intensive Medicine,Fourth People’s Hospital of Taiyuan)

机构地区：[1]山西省肿瘤医院重症医学科,太原030013 [2]山西省人民医院呼吸与危重症医学科 [3]山西省太原市第四人民医院重症医学科

出　　处：《山西医科大学学报》2020年第8期852-857,共6页Journal of Shanxi Medical University

摘　　要：目的分析山西省入住ICU的新型冠状病毒肺炎(COVID-19)患者临床特征。方法收集2020年1月21日至2020年3月13日山西省22例入住ICU的新型冠状病毒肺炎患者以及20例非ICU患者的临床资料,回顾性分析流行病学史、临床症状、实验室检查及治疗情况。结果发热、干咳、乏力和肌肉酸痛是COVID-19的常见症状。ICU与非ICU患者相比体温更高、呼吸频率更快;淋巴细胞计数显著下降(P<0.001)、血沉增快(P<0.001)、C反应蛋白升高(P=0.011)、丙氨酸氨基转移酶升高(P=0.037)、乳酸脱氢酶升高(P=0.005)。多重线性回归显示,淋巴细胞计数是ICU患者住院时间主要影响因素(P=0.003)。发病潜伏期7.00 d,ICU与非ICU患者发病潜伏期无差异,但核酸阳性持续时间ICU患者更长。结论体温、血沉、C反应蛋白、乳酸脱氢酶、淋巴细胞计数可作为重症患者的早期预警指标之一。ICU患者使用糖皮质激素,有可能降低病死率且不延长病毒清除时间。Objective To analyze the clinical features of patients with new coronavirus pneumonia(COVID-19)admitted to ICU in Shanxi province.Methods Clinical data from 22 patients admitted to the ICU and 20 non-ICU patients with COVID-19 from January 21,2020 to March 13,2020 in Shanxi Province were retrospectively analyzed,including epidemiological history,clinical symptoms,blood test and treatment.Results Fever,dry cough,fatigue,and muscle aches were the common symptoms of COVID-19.Compared with non-ICU patients,ICU patients had higher body temperature and faster respiratory rate.Compared with non-ICU patients,the lymphocyte count was decreased significantly in ICU patients(P<0.001),the erythrocyte sedimentation rate was increased(P<0.001),the C-reactive protein level was increased(P=0.011),the alanine aminotransferase level was increased(P=0.037),and the lactate dehydrogenase level was increased(P=0.005).Multiple linear regression showed that the lymphocyte count was the main influencing factor of ICU patients’hospital stay.The incubation period was 7.00 d for COVID-19,and there was no significant difference between ICU and non-ICU patients,but the duration of nucleic acid positive was longer in ICU patients.Conclusion Body temperature,erythrocyte sedimentation rate,C-reactive protein,lactate dehydrogenase,and lymphocyte count can be used as the early warning indicators for critically ill patients.The use of glucocorticoids in ICU patients may reduce the case fatality rate without prolonging the time for virus clearance.

关 键 词：新型冠状病毒肺炎 危重症 淋巴细胞减少 

分 类 号：R563.1[医药卫生—呼吸系统]