轻、重症新型冠状病毒肺炎临床及CT影像特征比较  

Comparison of clinical and CT imaging features of mild and severe patients with COVID-19

作　　者：刘明科 胡良波[1] 应洁 陈暇女 郭定波 李鹤[2] LIU Mingke;HU Liangbo;YING Jie;CHEN Xianü;GUO Dingbo;LI He(Department of Radiology, Yongchuan Hosiptal of Chongqing Medical University, Chongqing 402160, China;Department of hepatobiliary surgery, Yongchuan Hosiptal of Chongqing Medical University, Chongqing 402160, China)

机构地区：[1]重庆医科大学附属永川医院放射科,重庆402160 [2]重庆医科大学附属永川医院肝胆外科,重庆402160

出　　处：《暨南大学学报（自然科学与医学版）》2020年第5期405-412,共8页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：重庆市永川区科学技术局新冠肺炎疫情应急专项自然科学基金项目(Ycstc,2020nb0204,Ycstc,2020nb0208)。

摘　　要：目的:探讨新型冠状病毒肺炎(COVID-19)不同时期临床表现及胸部CT影像学特征,旨在为认识COVID-19病程进展及临床防治提供参考.方法:回顾性分析集中收治的COVID-19患者83例,将患者分为轻症组(轻型/普通型)、重症组(重型/危重型)两组,对两组病例不同时期临床表现、实验室指标及CT征象进行统计学分析.结果:本研究中轻症组67例(81%),重症组16例(19%),两组患者临床资料比较,年龄、最高体温、发热、气促、食欲差、肌肉酸痛、乏力、咳嗽、合并糖尿病、中性粒细胞计数百分比、淋巴细胞计数、单核细胞计数、C-反应蛋白(CRP)、红细胞沉降率(ESR)、动脉血氧分压(PaO2)、氧合指数等指标差异有统计学意义(均P<0.05),其中轻、重症患者平均年龄分别为(47.5±14.3)岁、(64.2±16.0)岁,轻、重症组患者合并糖尿病情况分别为4例(6.0%)、5例(31.3%);同一时期(分早期、进展期、重症期、恢复期共4期),两组病例1~4期累及肺段数:轻症组分别为(6.4±5.9)、(6.9±5.6)、(7.8±6.1)、(7.3±5.9),重症组分别为(12.4±5.4)、(15.7±3.0)、(14.8±3.3)、(15.9±2.8);两组病例1~4期肺部炎症指数:轻症组分别为(17.8±17.3)%、(20.5±17.9)%、(21.7±18.8)%、(20.7±19.6)%;重症组分别为(33.9±16.6)%、(53.1±15.2)%、(48.0±14.1)%、(50.5±13.3)%,同一时期两组病例累及肺段数、肺部炎症指数的差异均有统计学意义(P<0.05),同一分组病例不同时期累及肺段数、肺部炎症指数的差异均无统计学意义(P>0.05);多因素Logistic回归分析显示年龄、最高体温、累及肺段数是COVID-19重症组发病的独立危险因素(P<0.05).结论:本组COVID-19患者主要以轻型、普通型为主,高龄合并糖尿病患者更容易发展为重型COVID-19;同一时期重症组较轻症组病变累及肺段数更多、肺部炎症指数更大;同一组病例不同时期累及肺段数、肺部炎症指数差别不大;年龄、最高体温、累及肺段数是COVIDObjective:To explore the clinical manifestations and chest CT features of Corona Virus Disease 2019(COVID-19)at different stages,so as to provide reference for understanding the disease progress,clinical prevention and treatment of COVID-19.Methods:In present study,83 cases with COVID-19 admitted to our hospital were retrospectively analyzed.Patients were divided into two groups:mild group(mild/ordinary type)and severe group(severe/critical type).The clinical manifestations,inflammatory indicators and CT signs of the two groups at different periods were analyzed.Results:In this study,67 cases(81%)were in the mild group,16 cases(19%)were in the severe group,and there were remarkable differences(P<0.05)in the age,maximum body temperature,fever,shortness of breath,poor appetite,muscle ache,fatigue,cough combined with diabetes,percentage of neutrophil count,lymphocyte count,monocyte count,CRP,ESR,PaO2,and oxygenation index between the mild group and severe group.The average age of mild and severe patients was(47.5±14.3),(64.2±16.0)years old,the number of patients with diabetes in the mild and severe groups were 4(6.0%)and 5(31.3%).In the same period(early stage,progressive stage,peak stage and recovery stage),the results of involved lung segment and pulmonary inflammation index in different groups:the number of involved lung segments in the four stages of the mild group was(6.4±5.9),(6.9±5.6),(7.8±6.1)and(7.3±5.9),the number of involved lung segments in the four stages of the severe group was(12.4±5.4),(15.7±3.0),(14.8±3.3)and(15.9±2.8),and the pulmonary inflammation index in the four stages of the mild group was(17.8±17.3)%,(20.5±17.9)%,(21.7±18.8)%and(20.7±19.6)%,and the pulmonary inflammation index in the four stages of the severe group was(33.9±16.6)%,(53.1±15.2)%,(48.0±14.1)%and(50.5±13.3)%.In the same period,the differences in involved lung segment and pulmonary inflammation index in different groups(mild group and severe group)were statistically significant(P<0.05),and there was no significan

关 键 词：新型冠状病毒肺炎 临床表现 CT 肺部炎症指数 

分 类 号：R563.1[医药卫生—呼吸系统] R816.4[医药卫生—内科学]