新型冠状病毒肺炎患者初诊临床及肺部CT表现分析  

Analysis of early clinical manifestation and pulmonary CT features of COVID-19 cases

作　　者：田国保[1] 耿燕 孙静怡 张蔚 李珺[1] 董建平[1] Tian Guobao;Geng Yan;Sun Jingyi;Zhang Wei;Li Jun;Dong Jianping(Department of Infectious Disease,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀医院感染性疾病科,100080

出　　处：《北京医学》2020年第10期917-919,共3页Beijing Medical Journal

摘　　要：目的分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)发热门诊初诊患者的临床和影像学特征。方法回顾性分析2020年1月20日至2月20日北京市海淀医院发热门诊隔离留观的25例COVID-19确诊病例的临床和影像学资料。结果25例均具有明确流行病学史,6起为家庭聚集性病例。8例就诊时无任何临床表现,就诊时表现为发热11例,咳嗽11例,咽痛3例,乏力3例、全身酸痛2例,鼻塞流涕1例,腹泻1例。外周血常规淋巴细胞计数降低7例,外周血CRP轻度升高10例。25例患者就诊时均行胸部高分辨率CT(high resolution computed tomography,HRCT)检查:17例表现为胸膜下结节性或片状磨玻璃影,5例表现为双肺多发胸膜下片状磨玻璃影,部分实变,1例表现为双肺弥漫渗出和实变,呈"白肺"表现,2例无异常。结论COVID-19患者均有明确的流行病学史,临床主要表现为发热和咳嗽,部分外周血淋巴细胞计数减少,胸部HRCT多数表现为胸膜下结节性或片状磨玻璃影,部分病灶伴有实变,极少数患者无肺炎表现。Objective To investigate the early clinical manifestation and pulmonary CT features of COVID-19 cases.Methods A retrospective study was conducted to analyze the clinical and imaging data of 25 patients with SARS-CoV-2 infection diagnosed in Fever Clinicic in Beijing from January 20 th to February 20 th,2020.Results All the 25 confirmed COVID-19 cases had a clear epidemiological exposure history,and six cases were family clustering.There were no clinical manifestations in eight cases.When visiting the fiver clinic,and the clinical manifestations were fever in 11 cases,cough in 11 cases,pharyngeal pain in three cases,fatigue in three cases,general pain in two cases,nasal obstruction and runny nose in one case,diarrhea in one case.Lymphocyte count was decreased in seven cases,the level of C-reactive protein(CRP)of 10 cases was slightly increased.HRCT was performed in all 25 patients,17 cases showed subpleural nodular or flaky ground glass shadow,five cases showed multiple subpleural ground glass shadow,with partial consolidation,one case showed diffuse exudation and consolidation of both lungs,showing"white lung"appearance,and two cases showed no abnormality.Conclusions This group of cases with COVID-19 generally has certain epidemiological exposure history.The main clinical manifestations are fever and cough.Lymphocyte counts are reduced in some cases.Most of the chest HRCT show multiple pleural nodular or patchy glass opacity,some of them are accompanied by consolidation,and few patients has no pneumonia.

关 键 词：新型冠状病毒肺炎 体层摄影术 临床表现 

分 类 号：R563.1[医药卫生—呼吸系统]