不同严重程度新型冠状病毒肺炎患者肛拭子核酸检测阳性率及临床特点分析  

Analysis of the positive rate of anal swab nucleic acid test and clinical characteristics in patients with different severity of coronavirus disease 2019

作　　者：徐采云[1] 宋甲富 刘素霞[1] 郑慧[1] 康秀文[1] 李勇[1] 徐慧玲[1] 刘克喜[1] Xu Caiyun;Song Jiafu;Liu Suxia;Zheng Hui;Kang Xiuwen;Li Yong;Xu Huiling;Liu Kexi(Department of Intensive Care Medicine,the First People's Hospital of Lianyungang City,Lianyungang 222061,Jiangsu,China;Department of Respiratory,the First People's Hospital of Lianyungang City,Lianyungang 222061,Jiangsu,China)

机构地区：[1]连云港市第一人民医院重症医学科,江苏连云港222061 [2]连云港市第一人民医院呼吸科,江苏连云港222061

出　　处：《中华危重病急救医学》2020年第10期1171-1173,共3页Chinese Critical Care Medicine

基　　金：江苏省连云港市新冠肺炎应急防治科技专项(SF2009)。

摘　　要：目的分析不同病情严重程度新型冠状病毒肺炎(简称新冠肺炎)患者肛拭子标本2019新型冠状病毒(2019-nCoV)核酸检测阳性率及临床特点。方法回顾性分析2020年2月至3月连云港市第一人民医院收治的18例新冠肺炎确诊患者临床资料,按病情严重程度分为普通型组(11例)和危重症组(7例)。分析并比较两组性别、年龄、流行病学特点、入院后发热时间、有无基础疾病、入院及2次咽拭子2019-nCoV核酸检测阴性后肛拭子阳性率的差异。结果两组性别、年龄和入院后发热时间及有无基础疾病等差异均无统计学意义。危重症组入院时肛拭子2019-nCoV核酸阳性例数明显多于普通型组(例:4比1,P=0.047),2次咽拭子核酸检测阴性后,危重症组肛拭子阳性例数仍多于普通型组(例:2比0),但差异无统计学意义(P=0.137);危重症组非本地感染者较普通型组明显增多(例:4比0,P=0.011),4例非本地感染者均有武汉旅居史。结论肛拭子2019-nCoV核酸阳性可能预示更严重的病情,仅仅以两次咽拭子核酸阴性作为危重症患者转出隔离病房标准可能有风险;在武汉感染后返回当地的患者病情可能更严重。Objective To compared the positive rate of anal swab nucleic acid test and clinical characteristics of critical and general coronavirus disease 2019(COVID-19)patients.Methods Clinical data of 18 patients with COVID-19 admitted to the First People's Hospital of Lianyungang City from February to March 2020 were retrospectively analyzed.The patients were divided into general group(n=11)and critical ill group(n=7)according to the severity of the disease.The differences of gender,age,epidemiological characteristics,fever duration after admission,underlaying disease,positive rate of anal swab nucleic acid test at admission and two times of negative pharyngeal swab test were compared between the two groups.Results There were no significant differences in gender,age,fever duration after admission or underlaying disease between the two groups.The number of anorectal swab positive cases in critically ill group was significantly higher than that in general group(cases:4 vs.1,P=0.047).After two negative pharyngeal swab nucleic acid test,the number of anal swab positive cases in critical illness group was still higher than that in general group(cases:2 vs.0),but the difference was not statistically significant(P=0.137).The number of non-local infection in critical ill group was significantly higher than that in general group(cases:4 vs.0,P=0.047).All of the 4 non-local infected patients had a history of living in Wuhan.Conclusions The patients with anorectal swab nucleic acid positive may have a more serious condition.It may be a risk to transfer ill patients out of the isolation ward by the criteria of only two times of negative pharyngeal swab nucleic acid test.Patients returning to our city after infection in Wuhan may be more serious.

关 键 词：新型冠状病毒肺炎 肛拭子 病情严重程度 

分 类 号：R563.1[医药卫生—呼吸系统]