深圳市78例新型冠状病毒肺炎患者外周血实验室检查结果  

The laboratory results of blood samples from 78 cases of COVID-19 in Shenzhen

作　　者：刘许诺 何逸洲 蒋强[1] 蔡侃儒[1] 朱秀云[1] 马允建 张明霞[1] LIU Xunuo;HE Yizhou;JIANG Qiang;CAI Kanru;ZHU Xiuyun;MA Yunjian;ZHANG Mingxia(Institute of Hepatology,Shenzhen Third People’s Hospital,Shenzhen,Guangdong 518000,China)

机构地区：[1]深圳市第三人民医院肝病研究所,广东深圳518000

出　　处：《中国热带医学》2020年第10期984-987,共4页China Tropical Medicine

摘　　要：目的分析新型冠状病毒患者血液中各指标特点,为临床诊治提供理论依据。方法以明确诊断为新型冠状病毒肺炎的不同临床分型的78例患者为研究对象,分析其外周血白细胞、血清生化等指标检测结果,并对其中10例痊愈患者和3例死亡患者在病程早期(0~<10 d)、中期(10~<20 d)和后期(≥20 d)的上述各项指标进行动态观察。结果78例患者中,轻型7例,普通型50例,重型9例,危重型12例。与轻型和普通型患者相比,重型和危重型患者病程早期的淋巴细胞绝对值、T淋巴细胞亚群(CD3^+、CD4^+、CD8^+)明显降低,而CK显著升高(P<0.05),危重型患者的PCT、D-二聚体、AST、ALT以及MYO等指标均显著升高(P<0.05);10例痊愈患者中,部分患者早期(0~<10 d)IL-6和30%的C反应蛋白明显升高,病程中期(10~<20 d)部分患者出现LYM降低,NEUT和D-二聚体升高,病程后期(≥20 d)除C反应蛋白、D-二聚体和IL-6外,其余各项指标逐步恢复至正常水平。CK指标在整个病程过程中无明显变化。3例死亡患者病程早期(0~<10 d)的NEUT、PCT、D-二聚体、IL-6、CK、MYO、C反应蛋白等指标明显高于正常水平,LYM降低,一直到病程晚期(≥20 d)仍远高于正常水平的指标有D-二聚体、PCT、ALT、AST、CK、MYO和IL-6。MYO和IL-6在整个病程中呈进行性升高(P<0.05)。结论新型冠状病毒肺炎重型和危重型患者的炎症反应比轻型和普通型患者重,更易出现心肌和肝功能损伤;CK、MYO、IL-6、C反应蛋白等指标在病程早期的持续明显升高,可作为临床上判断患者病情程度,提示预后的重要参考指标。Objective To analyze the hematological characteristics of COVID-19,which may provide a foundation for clinical diagnosis and treatment.Methods The blood samples from 78 cases of different clinical types of COVID-19 were tested for the indexes of hematocyte and clinical chemistry.The dynamic changes of early(0-<10 d),middle(10-<20 d)and late(≥20 d)stage were observed in 10 cured cases and 3 death cases.Results The 78 cases were divided into mild group(n=7),common group(n=50),severe group(n=9)and critical group(n=12).Compared to mild group and common group,lymphocyte count(LYM)and T lymphocyte subsets(CD3^+,CD4^+,CD8^+)of early stage were decreased significantly in the severe and critical groups,while CK was increased(P<0.05).Procalcitionin(PCT),D-Dimer,AST,ALT and MYO were also increased significantly in critical group(P<0.05).For the 10 cured cases,IL-6 and CRP were increased significantly in some of patients in early stage(0-<10 d),lymphocyte count(LYM)was decreased while neutrophil count(NEUT)and D-Dimer were increased in some of patients in middle stage 10-<20 d.In the late stage(≥20 d),except for CRP,D-Dimer and IL-6,the other indexes gradually returned to normal level.CK and MYO had no significant change in the whole stage.For the 3 death cases,neutrophil count(NEUT),procalcitionin(PCT),D-Dimer,IL-6,CK and CRP was increased significantly,while lymphocyte count(LYM)was decreased in early stage(0-<10 d).D-Dimer,procalcitionin(PCT),AST,ALT,CK,MYO and IL-6 were still much higher than the normal level until the late stage(≥20 d).MYO and IL-6 were increased progressively in the whole stage(P<0.05).Conclusion COVID-19 patients in severe and critical type are more serious in inflammatory reaction,and more prone to myocardial and liver function injury.CK,MYO,IL-6 and CRP continue to increase significantly in the early stage,which may be useful in predicting severity and outcome for patients with COVID-19.

关 键 词：新型冠状病毒肺炎 临床分型 白细胞 血清生化 

分 类 号：R563.14[医药卫生—呼吸系统]