6例新型冠状病毒肺炎患者的临床特征与CT表现  

Clinical features and CT findings of 6 patients with COVID-19

作　　者：景赟杭[1] 冯旭霞[1] 沈美铖 刘青[1] 王雷 贾燕龙 朱洁 寇玉宁 李琦 JING Yun-hang;FENG Xu-xia;SHEN Mei-cheng;LIU Qing;WANG Lei;JIA Yan-long;ZHU Jie;KOU Yu-ning;LI Qi(Affiliated Hospital of Yan′an University,Yan′an 716000,China;Yanchuan County People′s Hospital,Yanchuan 717200,China)

机构地区：[1]延安大学附属医院,陕西延安716000 [2]延川县人民医院,陕西延川717200

出　　处：《延安大学学报（医学科学版）》2021年第1期18-21,共4页Journal of Yan'an University:Medical Science Edition

摘　　要：目的分析6例新型冠状病毒肺炎(COVID-19)的临床特征及CT表现,以提高临床对COVID-19的诊断能力。方法回顾性分析6例经病毒核酸检测确诊为COVID-19患者的临床及胸部CT资料,进行描述性分析。结果6例患者中男性4例,女性2例。年龄3~60岁,年龄中位数为39岁。4例(4/6)有1周内武汉返回某地病史,2例(2/6)有密切接触史。临床表现以发热(5/6)、乏力(5/6)、咳嗽(4/6)为主。实验室检查主要阳性指标有:淋巴细胞计数减少,C反应蛋白不同程度升高。CT显示6例患者中1例未见异常,其余5例共检出60个病灶。CT表现为:病变以双肺下叶多见(38/60;63.3%),主要分布于双肺外带(49/60,81.7%),以磨玻璃密度(51/60,85%)为著,部分为亚实性密度病变(7/60,11.7%),极少数为实性密度病变(2/60,3.3%),可伴有小血管增粗(8/60,13.3%)、铺路石征(7/60,11.7%)、支气管空气征(5/60,8.3%)、小叶间隔增厚(5/60,8.3%)、晕征(4/60,6.6%)、反晕征(3/60,5%)及胸膜平行征(2/60,3.3%)等伴随征象,边界模糊或欠清(60/60,100%)。所有病例均未发现纵隔及肺门肿大淋巴结,无心包及胸腔积液。结论COVID-19的胸部CT表现有一定的特征性,但少数病例早期CT表现不典型或正常。结合流行病史、临床表现、实验室检查及核酸检测综合考虑可早期诊断该病。Objective The clinical characteristics and CT manifestations of 6 cases of COVID-19 were analyzed to improve the clinical diagnostic ability of COVID-19.Methods The clinical and chest CT data of 6 patients confirmed with COVID-19 by viral nucleic acid test were retrospectively analyzed,and descriptive analysis was conducted.Results Among the 6 patients,4 were male and 2 were female.Ages 3 to 60,with a median age of 39.Four cases(4/6)had a history of returning to a place from Wuhan within one week,and two cases(2/6)had a history of close contact.The clinical manifestations were fever(5/6),fatigue(5/6)and cough(4/6).The main positive indexes of laboratory examination were:decreased lymphocyte count and increased C-reactive protein in different degrees.CT showed no abnormality in 1 of the 6 patients,and 60 lesions were detected in the other 5 patients.CT findings showed that the lesions were more common in the lower lobe of both lungs(38/60,63.3%),mainly distributed in the lung periphery(49/60,81.7%),with ground glass density(51/60%,85%),part of the solid density lesions(7/60,11.7%),very few for solid density lesions(2/60,3.3%),may be accompanied by small vessel enlargement(8/60,13.3%),paving stone sign(7/60,11.7%),bronchial air sign(5/60,8.3%),interlobular septal thickening(5/60,8.3%),halo sign(4/60,6.6%),,anti-halo(3/60,5%)and pleural parallel(2/60,3.3%)and so on,fuzzy or unclear boundary(60/60,100%).No enlarged lymph nodes in mediastinum or hilum,no pericardial mass or pleural effusion were found in all cases.Conclusion Chest CT findings of COVID-19 are characteristic,but a few cases show atypical or normal CT findings in the early stage.Early diagnosis of the disease can be made by combining epidemiological history,clinical manifestations,laboratory tests and nucleic acid tests.

关 键 词：新型冠状病毒 肺炎 临床特征 计算机体层成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]