新型冠状病毒肺炎42例临床特征及糖皮质激素应用分析  

Analysis of clinical features and glucocorticoid application of 42 cases of COVID-19

作　　者：蒋蕊[1] 段燕[2] 康伟霞 魏东光[1] 吴玉枝[1] 赵爱斌 Jiang Rui;Duan Yan;Kang Weixia;Wei Dongguang;Wu Yuzhi;Zhao Aibin(Department of Pulmonary and Critical Care Medicine,Shanxi Provincial People's Hospital,Shanxi Province,Taiyuan 030012,China;不详)

机构地区：[1]山西省人民医院呼吸与危重症医学科,太原030012 [2]山西省肿瘤医院重症医学科 [3]山西医科大学附属肺科医院重症医学科

出　　处：《疑难病杂志》2021年第1期53-57,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：山西省卫生健康委新冠科研项目(10)。

摘　　要：目的总结新型冠状病毒肺炎的临床特点及糖皮质激素治疗的效果。方法收集2020年1月1日—3月8日山西医科大学附属肺科医院收治的新型冠状病毒肺炎确诊病例42例的临床资料、流行病学史、影像学资料、血液生化资料,将患者分为重型/危重型组(n=24)和轻型/普通型组(n=18),比较2组上述资料相关指标和糖皮质激素治疗的疗效。结果2组患者在性别、年龄、BMI、基础疾病、吸烟史、旅行史及是否聚集性发病方面差异无统计学意义(P>0.05);重型/危重型组患者PaO_(2)、PaCO_(2)、外周血淋巴细胞、血磷、血肌酐水平较轻型/普通型组显著降低,CRP、ESR、ALT、AST、LDH较轻型/普通型组升高(t/Z=3.125、3.534、5.066、2.223、2.748、3.304、2.196、2.249、2.911,P<0.05);2组患者发病至确诊时间、影像学好转>50%时间、核酸转阴时间、累计住院时间等比较差异均无统计学意义(P>0.05);重型/危重型组患者胸部CT表现为双肺病灶较轻型/普通型组显著增多,其余影像学特点比较差异亦无统计学意义(P>0.05);2组患者均使用甲强龙治疗,重型/危重型组患者与轻型/普通型组患者在用药天数和累计用药剂量上比较差异无统计学意义(P>0.05),甲强龙累计使用剂量与咽拭子新型冠状病毒核酸转阴时间无相关性(r=0.255,P=0.117)。结论新型冠状病毒肺炎临床表现多样,重型/危重型患者实验室检查指标变化更明显,合理使用糖皮质激素是治疗新型冠状病毒肺炎的一种有效的方法。Objective To summarize the COVID-19 clinical characteristics and glucocorticoid treatment effect.Methods Forty two COVID-19 cases were collected from Affiliated Hospital of Shanxi Medical University Affiliated Hospital from January 1,2020 to March 8th.The clinical data,epidemiological history,imaging data and blood biochemical data were collected.The patients were divided into severe/critical group(n=24)and light/general group(n=18),and the relative data of the 2 groups and the efficacy of glucocorticoid treatment were compared.Results There were no significant differences in gender,age,BMI,underlying diseases,smoking history,travel history,and whether the two groups of patients were clustered(P>0.05);severe/critical group patients PaO_(2),PaCO_(2),peripheral blood lymphocytes,Blood phosphorus and blood creatinine levels were significantly lower in the mild/normal group,and CRP,ESR,ALT,AST,LDH were increased in the mild/normal group(t/Z=3.125,3.534,5.066,2.223,2.748,3.304,2.196,2.249,2.911,P<0.05);There were no significant differences in the time from onset to diagnosis,imaging improvement>50%,nucleic acid negative time,and cumulative hospital stay between the two groups(P>0.05);The chest CT of patients in the critical group showed significantly more lung lesions than the mild/normal group,and the difference in other imaging characteristics was not statistically significant(P>0.05);both groups were treated with methylprednisolone,severe/critical There was no significant difference in the number of days of medication and cumulative dose between patients in the type group and the mild/normal group(P>0.05).There was no correlation between the cumulative dose of methylprednisolone and the time for the new coronavirus nucleic acid in throat swabs to become negative(r=0.255,P=0.117).Conclusion The clinical manifestations of the COVID-19 are diverse,and the laboratory examination indicators of severe/critical patients have more obvious changes.The rational use of glucocorticoids is an effective method for the treatment

关 键 词：新型冠状病毒肺炎 临床特点 糖皮质激素 

分 类 号：R563.1[医药卫生—呼吸系统]