普通型2019冠状病毒病的临床特征和HRCT表现  

Clinical features and high-resolution CT findings of common coronavirus disease 2019

作　　者：孙中茹 张继[1] 夏建国[1] 王秀平[1] 朱明明[2] 王忠明[2] 田为中[1] SUN Zhong-ru;ZHANG Ji;XIA Jian-guo;WANG Xiu-ping;ZHU Ming-ming;WANG Zhong-ming;TIAN Wei-zhong(Taizhou People's Hospital;Taizhou Second People's Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院医学影像科 [2]泰州市第二人民医院医学影像科,江苏泰州225300

出　　处：《泰州职业技术学院学报》2021年第1期61-64,68,共5页Journal of Taizhou Polytechnic College

摘　　要：目的探讨普通型2019冠状病毒病(COVID-19)患者的临床表现与高分辨率CT(HRCT)的影像特征。方法回顾性分析我院收治的25例COVID-19确诊患者的临床资料及胸部CT检查,进一步分析其临床特征、实验室指标及HRCT影像学特征。结果我院收治的25例COVID-19患者均为普通型,发热(19/25,76%),干咳(18/25,72%);所有患者白细胞计数均正常,淋巴细胞计数不同程度减少(15/25,60%),血沉增快(12/25,48%),C反应蛋白升高(10/25,40%),出现降钙素原降低(2/25,8%);平均住院日为19.8±3.9天,从出现临床症状到CT检查阳性平均时间为4.9±2.7天。首次胸部HRCT病灶分布为单侧9例(36%,左肺4/25,16%;右肺5/25,20%),双侧16例(64%);20例(80%)病灶分布位于周边,5例(20%)位于周边为主及中心同时受累。HRCT表现中单纯磨玻璃影(GGO)为25例(100%),GGO伴局灶性实变为5例(20%),4例(16%)伴片状实变影。在第二次HRCT检查中,大部分患者病灶增多、范围变广,局部病灶融合,并见支气管充气征。结论普通型COVID-19患者临床表现相对较轻,HRCT是其诊断和评估的重要手段。Objective To explore clinical manifestations of COVID-19 and their image features of high-resolution CT(HRCT).Methods Clinical data and chest CT examination results of 25 COVID-19 patients admitted to our hospital were retrospectively collected for analyzing their clinical features,laboratory indicators and HRCT features.Results Twenty-five COVID-19 patients admitted to our hospital were common cases,and 19/25(76%)developed fever,and 18/25(72%)developed dry cough.White blood cell count of them was all normal,whilst 15/25(60%)cases presented a decrease in lymphocyte count to varying degrees,12/25(48%)had in⁃creased erythrocyte sedimentation rate,10/25(40%)had elevated CRP and 2/25(8%)had decreased procalcito⁃nin.The average length of stay was 19.8±3.9 days,and the average time from clinical symptoms to positive CT examination was 4.9±2.7 days.9/25(36%)cases were examined with unilateral lesion by the first time of chest HRCT,including left-side lesion in 4/25(16%)cases,and right-side lesion in 5/25(20%).Besides,16/25(64%)cases had bilateral lesions,including 20/25(80%)cases with peripheral lesions,and 5/25(20%)with peripheral le⁃sions and involvement of the center.HRCT examination results showed ground glass shadow(GGO)in 25/25(100%)cases,GGO combined with focal consolidation in 5/25(20%)cases,and patchy consolidation in 4/25(16%)cases.The second time of HRCT examination revealed that in most patients,the number of lesions in⁃creased,and the lesion scope became wider.Besides,the local lesions were fused,and bronchial inflation was identified.Conclusions Clinical manifestations of common COVID-19 cases are relatively mild,and HRCT is an important approach for diagnosing and assessing COVID-19.

关 键 词：2019冠状病毒病 HRCT 

分 类 号：R511[医药卫生—内科学] R445.3[医药卫生—临床医学]