生化及炎症指标在新型冠状病毒肺炎患者中的变化特征和应用价值  

Characteristics and application of biochemical and inflammatory indicators in COVID-19 patients

作　　者：吕宁[1] 陆加刚[1] 罗莎莎[1] 肖颜玉[1] 吴驰[1] 张文萍[1] 曲久鑫 LYU Ning;LU Jiagang;LUO Shasha;XIAO Yanyu;WU Chi;ZHANG Wenping;QU Jiuxin(Department of Clinical Laboratory,Third People′s Hospital of Shenzhen,Shenzhen,Guangdong 518020,China)

机构地区：[1]深圳市第三人民医院检验科,广东深圳518020

出　　处：《国际检验医学杂志》2020年第20期2501-2505,共5页International Journal of Laboratory Medicine

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)患者入院首日的生化及炎症指标结果,以及不同临床分型患者的相关指标变化情况和在早期临床诊断中的价值。方法回顾性分析2019年12月至2020年2月该院收治住院的246例COVID-19患者的临床资料,依据诊断标准分为轻症组患者(n=198)、重症组患者(n=48)。比较和分析不同组别患者的生化及炎症指标结果,评估炎症指标在疾病临床分型诊断中的价值。结果两组患者C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素(IL)-6、总蛋白(TP)、清蛋白(ALB)、γ-谷胺酰转肽酶(GGT)、直接胆红素(DBIL)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、尿素(Urea)、肌酐(Cr)、胱抑素C(Cys-C)、氯离子(Cl-)水平比较,差异有统计学意义(P<0.05)。CRP、PCT和IL-6单独检测时诊断重症COVID-19患者的曲线下面积(AUC)分别为0.825、0.746、0.756。CRP与IL-6联合检测的诊断效能最佳,AUC为0.851,灵敏度为85.42%,特异度为73.23%。结论COVID-19患者早期的生化及炎症指标多为正常,而重症患者部分生化指标变化更显著,提示受损程度高。炎症指标CRP、IL-6的联合检测可用于鉴别诊断重症COVID-19。Objective To analyze the Corona Virus Disease 2019(COVID-19)patients′biochemical and inflammatory indicators on the first day of admission,as well as the changes in related indicators of patients with different clinical types and their value in early diagnosis.Methods Clinical data of 246 COVID-19 patients from December 2019 to February 2020 were retrospectively analyzed.According to the diagnostic criteria,patients were divided into mild group(n=198)and severe group(n=48).The biochemical and inflammatory indexes of different groups of patients were compared and analyzed,and the value of inflammatory indicators were evaluated in identification the clinical types.Results Levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin(IL)-6,total protein(TP),albumin(ALB),gamma glutamyltranspeptidase(GGT),direct bilirubin(DBIL),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),Urea,creatinine(Cr),Cystatin C(Cys-C)and chloride ion(Cl-)between the two groups had statistical significances(P<0.05).AUC of single detection of CRP,PCT and IL-6 in diagnosis severe COVID-19 were 0.825,0.746 and 0.756.The combined detection of CRP and IL-6 had the best diagnostic value,AUC was 0.851,sensitivity was 85.42%and specificity was 73.23%.Conclusion The biochemical and inflammatory indicators in the early stage of patients with COVID-19 are mostly normal,while the changes of the indicators in severe patients is obvious,and the degree of damage in high.The combined detection of CRP and IL-6 can be used to differentiate severe COVID-19.

关 键 词：新型冠状病毒肺炎 炎症指标 灵敏度 特异度 

分 类 号：R446.1[医药卫生—诊断学]