新型冠状病毒肺炎患者入院时临床特征及致死亡危险因素分析  

Clinical characteristics on admission and risk factors for fatal outcome in patients with COVID-19

作　　者：熊维[1] 王海蓉[1] 吴晓燕[1] 范永臻 何涛 罗慧敏 郭涛[1] 张琳[1] 曹建雷[1] 万静[1] 鲁志兵 陈明[1] XIONG Wei;WANG Hairong;WU Xiaoyan;FAN Yongzhen;HE Tao;LUO Huimin;GUO Tao;ZHANG Lin;CAO Jianlei;WAN Jing;LU Zhibing;CHEN Ming(Dept.of Cardiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院心内科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2021年第1期6-9,共4页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金资助项目(编号:2018CFB475)。

摘　　要：目的:回顾性分析新型冠状病毒肺炎(COVID-19)患者入院时临床特征及致死亡危险因素。方法:收集2020年1—2月在武汉市第七医院住院123例的COVID-19患者。比较治愈患者和死亡患者入院时的临床特征,住院期间并发症及治疗情况。结果:死亡组相比于治愈组的男性患者更多,年龄更大,合并有高血压病及冠心病病史比例更大。Logistic回归分析结果提示入院时肌钙蛋白T、D-二聚体、PaO2/FiO2和高敏C反应蛋白是预测死亡的独立危险因素。相比于治愈组,死亡组更容易出现急性呼吸窘迫综合征(ARDS)、心肌损伤、凝血障碍、肾损伤和休克等并发症,激素治疗和呼吸支持比例更高。结论:患者入院时临床特征能够帮助早期判断不良预后及死亡风险,对不同危险程度患者进行分流有重要的指导意义。Objective:To retrospectively analyze the clinical characteristics on admission and risk factors for fatal outcome in patients with COVID-19.Methods:From January to February 2020,data was retrospectively collected from 123 patients with COVID-19 at the Seventh Hospital of Wuhan City.Initial clinical characteristics and laboratory findings on admission,the complications and treatment during hospitalization were compared between survivors and non-survivors.Results:Compared with the cured group,the death group had a higher percentage of males,were older,and had higher rates of preexisting hypertension and coronary heart disease.The logistic regression analysis indicated that TnT,D-dimer,PaO2/FiO2,and hs-CRP independently predicted mortality.The death group was more commonly to have complications of acute respiratory distress syndrome(ARDS),acute cardiac injury,acute coagulopathy,acute kidney injury and shock as compared with the cured group.The death group adopted a significantly higher percentage of hormone therapy and respiratory support as compared with the cure group.Conclusion:The clinical characteristics on admission may help early detection of the high-risk patients with poor prognosis and funnel the flow of patient with COVID-19.

关 键 词：新型冠状病毒肺炎 危险因素 死亡 预后 

分 类 号：R563.1[医药卫生—呼吸系统]