新型冠状病毒肺炎核酸复阳患者与未复阳患者临床特征比较  

A comparison of clinical characteristics between patients with and without“recurrence”RNA positive with COVID-19

作　　者：施丽泳[1] 蔡艳萍 张祎祥[1] 林亚兰 林连顺 丁锦珍 郭建欣[1] 庄锡彬[3] 陈晓阳[1] 曾奕明[1] Shi Liyong;Cai Yanping;Zhang Yixiang;Lin Yalan;Lin Lianshun;Ding Jinzhen;Guo Jianxin;Zhuang Xibin;Chen Xiaoyang;Zeng Yiming(Department of Pulmonary and Critical Care Medicine,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Department of Infectious Diseases,Wuhan Jinyintan Hospital,Wuhan 430040,China;Department of Pulmonary and Critical Care Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院呼吸与危重症医学科,泉州362000 [2]武汉市金银潭医院感染科,430040 [3]福建医科大学附属泉州市第一医院呼吸与危重症医学科,362000

出　　处：《中华结核和呼吸杂志》2020年第12期1066-1070,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：福建医科大学应急攻关项目计划(2020YJ008)。

摘　　要：目的分析新型冠状病毒(新冠病毒)肺炎(COVID-19)病毒核酸检测“复阳”患者的临床特征分析,并与未“复阳”患者进行比较。方法选取2020年2―4月在武汉市金银潭医院和泉州市定点治疗医院收治的98例COVID-19患者为研究对象,男55例,女43例,年龄15~83岁,中位年龄为57.5岁,均为普通型,其中20例伴有基础疾病。98例中15例住院治疗好转出院后复查咽拭子新冠病毒核酸阳性。收集患者的一般情况、临床症状、实验室检查及胸部CT影像学特征,并根据核酸检测结果将患者分为新冠病毒“复阳”组与未“复阳”组,“复阳”组男10例,女5例;非“复阳”组男45例,女38例,性别无统计学差异(χ²=0.800,P=0.371);“复阳”组平均年龄为(57±21)岁,未“复阳”组为(53±17)岁;“复阳”组中8例伴有基础疾病,未“复阳”组12例。检测2组的血常规、IL-6、C反应蛋白(CRP)、降钙素原(PCT)、ESR、B型钠尿肽(BNP)、生化全套、新冠病毒IgG和IgM抗体等指标,并进行比较。结果(1)98例患者出院后2周内有15例(15.3%)患者病毒核酸检测“复阳”。(2)“复阳”患者均在定点隔离场所复查病毒核酸阳性后再次入院治疗,自觉症状轻微,其中5例发热,6例咳嗽,5例咳痰,2例稍感气促。症状出现在出院后平均(5.7±2.8)d。(3)“复阳”患者PCT(均<0.05μg/L)均正常。“复阳”组BNP为(151±171)ng/L,稍高于“复阳”组的(63±78)ng/L,差异有统计学意义(t=3.207,P=0.000)。“复阳”组与未“复阳”组白细胞计数[(6.17±2.45)和(6.04±2.41)×10^9/L]、淋巴细胞计数[(1.59±0.52)和(1.32±0.64)×10^9/L]、CRP[(12.54±28.20)和(21.74±25.63)mg/L]、ESR[(31.07±28.72)和(34.10±22.16)mm/1 h]、天冬氨酸氨基转氨酶[(24.73±9.15)和(30.24±23.20)U/L]、丙氨酸氨基转氨酶[(22.60±12.82)和(36.47±34.12)U/L]、乳酸脱氢酶[(268±208)和(270±164)U/L]、D-二聚体[(0.60±0.50)和(0.84±0.98)μg/L]、铁蛋白[(294±195)和(395±319)μg/L]Objective To analysis the clinical characteristics of“recurrence”RNA positive patients with Coronavirus disease 2019(COVID-19)and compared with those without“recurrence”.Methods 98 patients with COVID-19 in Wuhan Jinyintan Hospital and designated treatment hospitals in Quanzhou were included in this study from February 2020 to April 2020.There were 55 males and 43 females,aged from15 to 83 years,with a median age of 57.5 years,in which 20 cases were complicated with basic diseases.15 of these patients had been diagnosed and hospitalized had been found as“recurrence”2019-nCoV RNA positive after discharge while the other 83 cases were all negative.The clinical classification of all patients was common type.Clinical data of the COVID-19 RNA“recurrence”patients were collected,and general situations,symptoms,laboratory examinations and CT images were also observed and analyzed.The patients were divided into 2019-nCoV“recurrent”group and 2019-nCoV“non-recurrent”group.There are 10 males and 5 females in 2019-nCoV“recurrent”group while 45 males and 38 females in“non-recurrent”group(χ²=0.800,P=0.371).The age of 2019-nCoV“recurrent”group(57±21)was higher than that of“non-recurrent”group(53±17).8 of 15 the COVID-19“recurrent”group patients and 12 of 83“non-recurrent”patients have basic diseases.IgG and IgM of 2019-nCoV,IL-6,procalcitonin,ESR,CRP,BNP and other serum biochemical index levels were measured and compared between groups.Results(1)The proportion of patients with common type of COVID-19 was 15.3%during 2-week medical observation after discharge.(2)All of the 2019-nCoV“recurrent”patients were hospitalized due to COVID-19 RNA positive,when they were quarantined after discharged from hospital.All the patients with mild symptoms which were clarified as common type,including 5 cases of fever,6 cases of cough,5 cases of expectoration,and 2 cases of slight shortness of breath.The time of symptoms appeared on(5.73±2.82)days after discharge.(3)The serum procalcitonin

关 键 词：新型冠状病毒肺炎 核酸检测 复阳 

分 类 号：R563.1[医药卫生—呼吸系统]