76例新型冠状病毒肺炎患者实验室特征分析  

Analysis on laboratory characteristics of 76 cases of COVID-19

作　　者：冯霞[1] 王颖[1] 冯英梅 房忠军 孔繁军[2] 孟莎[2] 淘丽玲 党燕[1] 娄金丽[1] Feng Xia;Wang Ying;Feng Yingmei;Fang Zhongjun;Kong Fanjun;Meng Sha;Tao Liling;Dang Yan;Lou Jinli(The Clinical Laboratory Center of Beijing Youan Hospital Affiliated to Capital Medical University,Beijing 100069,China;Scientific Research Department of Beijing Youan Hospital Affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院临检中心,100069 [2]首都医科大学附属北京佑安医院科技处,100069

出　　处：《国际病毒学杂志》2020年第4期283-286,共4页International Journal of Virology

摘　　要：目的通过分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者的临床特征、早期实验室检测以及病毒学标志物特征,为COVID-19的临床诊疗提供理论依据。方法回顾性分析2020年1月21日至6月8日,首都医科大学附属北京佑安医院确诊和随访的76例COVID-19患者流行病学资料和实验室检测结果,采用Mann-Whitney U检验和x2检验,比较各指标在不同临床分型中的差异。结果纳入分析的COVID-19临床确诊患者中,普通型54例,重型22例,重型患者组中位年龄为64.3(52.0,71.0)岁,大于普通组的42.5(35.5,57.0)岁(P<0.01);患者入院后首次血细胞分析中,重型患者组白细胞计数高于普通型组(P=0.042),淋巴细胞计数低于普通型组(P=0.037),淋巴细胞百分比(lymphocyte ratio,LYM%)和嗜酸性粒细胞百分比(eosinophil ratio,EOS%)低于普通型组(P<0.01)。心脏功能检测项目中,重型患者组肌酸激酶同工酶、肌红蛋白高于普通型组(P<0.01),肌钙蛋白高于普通型组(P=0.037)。C反应蛋白(C-reactive Protein,CRP)高于普通型患者组(P<0.01);76例患者中,IgM抗体阴转时间的中位数为57(19,82)d;76例患者随访过程中均检测到IgG抗体阳性,11例患者观察到IgG抗体阴转,其中10例为普通型患者,1例为重型患者。结论COVID-19重症患者发病年龄大,伴有早期LYM%和EOS%降低、CRP升高。随着感染时间延长,IgG抗体有可能阴转,发病后3周至2个月内IgG抗体检测用于COVID-19的辅助诊断较为可靠。Objective To analyze the clinical features,characters of early laboratory testing results and viral markers of coronavirus disease 2019(COVID-19)patients,so as to provide therotical basis for clinical diagnosis of COVID-19.Methods The epidemiological data of 76 cases of COVID-19 admitted and followed in Beijing You'an Hospital,Capital Medical University from January 21 to June 8,2020 and the laboratory detection results were analyzed retrospectively.Mann-Whitney U test and chi-square test were used to compare the differences of each index in different clinical types.Results Among the 76 clinically confirmed COVID-19 cases included in the analysis,54 were moderate cases and 22 were severe cases.The median age of severe patients was 64.3(52.0,71.0)years old and was significantly higher than the median age of 42.5(35.5,57.0)years old of the moderate cases(P<0.01).In the first blood cell analysis after admission,white blood cell counts of the severe cases were higher than that of the moderate group(P=0.042)while lymphocyte counts were lower than the moderate group(P=0.037).The lymphocyte ratio(LYM%)and eosinophil ratio(EOS%)were significantly lower in the severe case group than that of the moderate group(P<0.01).In the cardiac function tests,creatine kinase-MB isoenzyme(CK-MB)among severe cases were significantly higher than those in moderate patients(P<0.01),and myoglobin(MYO)was slightly higher than that among moderate cases(P=0.037)while c-reactive protein(CRP)was significantly higher than that among moderate cases(P<0.01).Among the 76 patients,the median value of IgM antibody negative conversion was 57(19,82)days.IgG antibody was detected in all 76 patients and the negative conversions were observed in 11 patients,including 10 moderate cases and one severe case.Conclusions The severe cases were commonly older in the onset age accompanied with lower LYM%and EOS%and the elevated CRP.The IgG antibody may change from positive to negative along with the extension of infection time.It is more reliable to use IgG as a C

关 键 词：新型冠状病毒 新型冠状病毒肺炎 临床特征 病毒标志物 

分 类 号：R563.1[医药卫生—呼吸系统]