妊娠合并新型冠状病毒肺炎29例的临床分析  

Clinical study of corona virus disease 2019 in 29 pregnant women

作　　者：田金华 何松明[1] 魏敏[1] 程苾恒[1] 罗亭 江燕 李秉枢[1] 李洁[1] 朱楚超 杨菁[1] Tian Jinhua;He Songming;Wei Min;Cheng Biheng;Luo Ting;Jiang Yan;Li Bingshu;Li Jie;Zhu Chuchao;Yang Jing(Department of Obstetrics and Gynecology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Obstetrics and Gynecology,General Hospital of Central Command Theater in PLA,Wuhan 430070,China)

机构地区：[1]武汉大学人民医院妇产科,430060 [2]解放军中部战区总医院妇产科,武汉430070

出　　处：《中华传染病杂志》2020年第10期621-625,共5页Chinese Journal of Infectious Diseases

摘　　要：目的分析妊娠合并新型冠状病毒肺炎(COVID-19)患者的临床资料,研究其在妊娠女性中的发病与诊治特点。方法收集2020年1月30日至2月23日武汉大学人民医院收治的29例妊娠合并COVID-19患者的病历资料并进行回顾性分析,总结其发病特点及诊治经验。以出现发热、咳嗽、乏力、胸闷等呼吸道症状当天为发病的第1天,发病第1周入院为组1,发病第2周入院为组2。统计学分析采用t检验和Mann-Whitney U检验。结果29例患者年龄范围为24~40岁,孕早、中、晚期者各有5、5、19例,普通型患者28例,重型患者1例,大多以发热、咳嗽、乏力等为首发症状。29例患者中,组1有14例,组2有9例,6例为无症状患者。入院当天实验室检查显示22例患者出现淋巴细胞比例减低,2例患者细胞免疫(CD3+T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞、CD19+T淋巴细胞、CD16+CD56+T淋巴细胞计数)检查结果均降低,上述检查结果在组1和组2患者中差异均无统计学意义(均P>0.05)。组1和组2患者的IgE[28.45(18.30,51.70)IU/mL和20.30(18.30,75.80)IU/mL]和补体C3[(1.219±0.320)g/L和(1.170±0.147)g/L]差异均有统计学意义(U=67222.000,t=0.442,P=0.024、0.028)。29例患者初次胸部计算机断层成像检查均可见磨玻璃样病毒性肺炎征象。患者以吸氧、抗病毒、抗感染等常规治疗为主,对重症患者和在常规治疗过程中出现症状恢复较慢甚至加重的普通型患者可酌情使用甲泼尼龙、丙种球蛋白等治疗。孕早、中期患者中无流产及早产者,孕晚期患者中有3例早产临产,1例孕35周入院的患者行期待治疗至孕37周+6时行剖宫产术,13例孕足月患者均在入院后行急诊剖宫产术。17名新生儿鼻咽拭子2019新型冠状病毒核酸检测均为阴性。19例患者治愈出院,病程为(19.60±5.38)d。10例在院患者仍有轻微症状。结论妊娠合并COVID-19患者的病情普遍较轻,恢复较快,合并心、肝、肾等脏器功Objective To analyze the clinical data of corona virus disease 2019(COVID-19)in pregnant women,and to study the characteristics of disease onset,diagnosis and treatment in pregnant women complicated with COVID-19.Methods The clinical data of 29 pregnant women with COVID-19 hospitalized in Renmin Hospital of Wuhan University from January 30 to February 23,2020 were retrospectively analyzed.The disease characteristics and experiences of diagnosis and treatment were concluded.The first day of onset was defined as the day when respiratory symptoms such as fever,cough,fatigue,and chest tightness occurred.Group one was admitted to the hospital within the first week of onset,and group two was hospitalized during the second week of onset.Statistical analysis was conducted by t test and Mann-Whitney U test.Results The age of 29 patients ranged from 24 to 40 years old,with fever,cough and fatigue as the initial symptoms.There were five cases in the first trimester of pregnancy,five cases in the second trimester and 19 cases in the third trimester of pregnancy.There were 28 ordinary patients and one severe patient.Among the 29 patients,14 were hospitalized in the first week of onset(group one),nine in the second week of onset(group two),and the remaining six were asymptomatic.On the day of admission,22 patients showed lymphocytopenia in complete blood count and all the indicators of cellular immunity(CD3+,CD4+,CD8+,CD19+,CD16+CD56+T lymphocytes)were reduced in two patients.There were no significant differences between patients in group one and group two(all P>0.05).The levels of IgE and complement 3 were 28.45(18.30,51.70)IU/mL and(1.219±0.320)g/L in group one,and 20.30(18.30,75.80)IU/mL and(1.170±0.147)g/L in group two.The differences were statistical significance(U=67222.000,t=0.442,P=0.024、0.028).Primary chest computed tomography revealed ground-glass opacity in all 29 cases,which was considered as the diagnostic marker of viral pneumonia.Conventional therapy such as oxygen inhalation,antiviral,anti-infection was the

关 键 词：冠状病毒感染 肺炎 2019新型冠状病毒 发热 传染性疾病传播 垂直 

分 类 号：R512.99[医药卫生—内科学]