新型冠状病毒肺炎合并2型糖尿病患者的临床特征及预后分析  

Clinical characteristics and prognosis of patients with corona virus disease-19 and type 2 diabetes mellitus

作　　者：施金枝[1] 戴锴[1] 张倩[1] 杨凡[1] 陈晓蓓[1] Shi Jinzhi;Dai Kai;Zhang Qian;Yang Fan;Chen Xiaobei(Department of Infectious Diseases,Renmin Hospital of Wuhan University,Wulum 430060,China)

机构地区：[1]武汉大学人民医院感染科,430060

出　　处：《中国医药》2021年第5期688-692,共5页China Medicine

基　　金：国家自然科学基金(81972673);2020年武汉大学教学研究项目(YB-1)。

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)合并2型糖尿病患者的临床特征及预后。方法收集武汉大学人民医院东院区2020年2月1日至2020年3月10日收治的76例COVID-19合并2型糖尿病患者的临床资料。总结患者的临床特征及预后。结果76例患者中,男、女各占50.0%,平均年龄为(68±10)岁,普通型15例(19.7%)、重型37例(48.7%)、危重型24例(31.6%)。临床表现主要为发热(64例,84.2%)、干咳(50例,65.8%)和乏力(51例,67.1%)等。与普通型和重型患者比较,危重型患者的白细胞计数、中性粒细胞计数、天冬氨酸转氨酶、血尿素氮、血糖、乳酸脱氢酶、C反应蛋白>10 mg/L者比例、D-二聚体、N末端B型脑钠肽前体、肌酸激酶同工酶、肌红蛋白、高敏心肌肌钙蛋白I(hs-cTnI)>0.04μg/L者比例均高,而淋巴细胞计数、血小板计数、白蛋白水平、CD3、CD4、CD8细胞计数均低(均P<0.05)。76例患者中,出现呼吸衰竭26例(34.2%)、急性心肌损伤9例(11.8%)、休克6例(7.9%)、肾衰竭3例(3.9%);好转出院55例(72.4%)、死亡21例(27.6%),死亡者均为危重型患者,3组患者的病死率差异有统计学意义(P<0.05)。结论COVID-19合并2型糖尿病患者的病死率相对较高,其中危重型患者更容易出现多器官功能损害,预后更差。Objective To investigate the clinical characteristics and prognosis of patients with corona virus disease-19(COVID-19)and type 2 diabetes mellitus.Methods The clinical data of 76 diabetic cases with COVID-19 in East District of Renmin Hospital of Wuhan University from February 1 to March 10,2020 were collected.The clinical characteristics and prognosis were summarized.Results Among 76 cases,male and females accounted for 50.0%and 50.0%,respectively,with an average age of(68±10)years.There were15 cases of ordinary type(19.7%),37 cases of severe type(48.7%)and 24 cases of critical type(31.6%).The main clinical manifestations were fever(64 cases,84.2%),dry cough(50 cases,65.8%),weakness(51 cases,67.1%)and so on.Compared with the patients in ordinary type and severe type,white blood cell count,neutrophil count,aspartate transaminase,blood urea nitrogen,blood glucose,lactate dehydrogenase,ratio of C-reactive protein>10 mg/L,D-dimer,N terminal pro-brain natriuretic peptide,creatine kinase isoenzymes,myoglobin,ratio of high-sensitivity cardiac troponin I(hs-cTnI)>0.04μg/L in critical type were higher;while the lymphocyte count,platelet count,albumin level,and the counts of CD3,CD4 and CD8 cells in critical type were lower(all P<0.05).Among the 76 cases,26 cases(34.2%)had respiratory failure,9 cases(11.8%)had acute myocardial injury,6 cases(7.9%)had shock and 3 cases(3.9%)had renal failure.There were 55 cases(72.4%)discharged after improvement,and 21 cases(27.6%)died,all of the death cases were in the critical type.There was a significant difference in mortality among the patients of three types(P<0.05).Conclusions The mortality of type 2 diabetes mellitus patients with COVID-19 is relatively high.Critical patients are more likely to have multiple organ dysfunction and poor prognosis.

关 键 词：新型冠状病毒肺炎 2型糖尿病 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]