宁夏地区新型冠状病毒肺炎患者临床特征分析  

Clinical characteristics of 75 patients with COVID-19 in Ningxia

作　　者：张淑香[1] 纳建荣[1] 李静 严梅 周玮[1] ZHANG Shuxiang;NA Jianrong;LI Jing;YAN Mei;ZHOU Wei(General Hospital of Ningxia Medical University,Yinchuan 750004,China;The Fourth People’s Hospital of Ningxia,Yinchuan 750021,China)

机构地区：[1]宁夏医科大学总医院,宁夏银川750004 [2]宁夏回族自治区第四人民医院,宁夏银川750021

出　　处：《宁夏医学杂志》2021年第5期431-435,共5页Ningxia Medical Journal

基　　金：宁夏重点研发计划科技支撑项目(2020BEG003004)。

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)患者的临床特征,为疫情期间的临床诊治提供参考依据。方法以75例确诊新型冠状病毒肺炎(NCP)的患者为研究对象,收集全部患者的临床资料,分析其流行病学、临床表现及实验室和肺影像学等特征,总结治疗及预后特点。结果75例患者的平均年龄为(39.93±17.81)岁,男女比例差异无统计学意义;临床表现中,75例患者有发热51人(68.00%),咳嗽60人(80.00%),咳痰37人(49.33%),头痛13人(17.33%),肌肉酸痛15人(20.00%),咯血9人(12.00%),腹痛腹泻18人(24.00%),胸闷气短17人(22.67%),胸痛7人(9.33%)。患者按疾病爆发2周时间为分界线,性别、年龄差异均无统计学意义,临床表现在发热情况上差异有统计学意义(P<0.05)。实验室检查中外周血一般表现为白细胞总数正常或减低(96.00%),淋巴细胞计数减低(16.00%)。C-反应蛋白(CRP)、血沉及降钙素原测定多为正常,T淋巴细胞亚群的结果也以正常范围多见。个别患者肝肾功能轻度损害。6例患者第三次或第三次以上核酸检测阳性才得以确诊。重型患者血沉、丙氨酸氨基转移酶和D-二聚体升高多见。确诊病例中伊朗境外输入3例,无任何接触史者16例,武汉居住或逗留后发病18例(第一代),与第一代发病患者接触发病15例(第二代),与第二代患病者接触而发病23例(第三代)。典型病例的CT表现为双肺多发局灶性磨玻璃影及混合密度影,胸膜下及支气管血管束周围分布多见。所有患者接受一般治疗外,均以α-干扰素雾化吸入、洛匹那韦/利托那韦抗病毒治疗为主,75例患者预后良好,截至3月16日全部患者均出院。结论宁夏75例NCP均为输入型,人传人发病,传染性强,传播速度快,密切接触及家庭聚集造成疾病的暴发,其临床特征与一般病毒性肺炎类似;两次核酸检测阴性不能排除NCP,高分辨率CT有助于鉴别诊断;早发现,早隔离、早诊断、早治疗,预后�ObjectiveTo explore clinical characteristics of patients with coronavirus disease 2019(COVID-19)and provide reference for clinical diagnosis and treatment of the COVID-19.MethodsThe novel coronavirus pneumonia(NCP)patients who were admitted to the Fourth People’s Hospital of Ningxia from January 22,2020 to March 3,2020 were selected as the subjects.The clinical data include epidemiology,clinical manifestations,laboratory indicates and pulmonary imaging characteristics were analyzed,also summarized characteristics of treatment and prognosis.ResultsThe average age of 75 patients was(39.93±17.81)years old,and there was no significant difference between male and female.Among the 75 patients,51(68.00%)had fever,60(80.00%)had cough,37(49.33%)had expectoration,13(17.33%)had headache,15(20.00%)had muscle soreness,9(12.00%)had hemoptysis,18(24.00%)had abdominal pain and diarrhea,17(22.67%)had shortness of breath,chest pain in 7 cases(9.33%).According to the time of two weeks of disease outbreak,there was no significant difference in patient’s gender and age.The clinical manifestation of fever was significantly difference,and the other clinical manifestations were no significantly difference;96%of patients showed normal or decreased white blood cell count,16%showed decreased lymphocyte count.C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and procalcitonin were mostly normal,and the results of T lymphocyte subsets were normal.The liver and kidney function of very few patients was slightly damaged.Six patients were diagnosed after the third or more nucleic acid test.The increase of ESR,alanine aminotransferase and D-dimer were common in severe patients;Among the confirmed cases,there were three imported cases from Iran,16 cases without any contact history,18 cases(first generation)had lived or stayed in Wuhan,15 cases(second generation)contacted with first generation patients,and 23 cases(third generation)contacted with second generation patients;The typical CT findings were multiple focal ground glass opaci

关 键 词：新型冠状病毒肺炎 新型冠状病毒 临床特征 

分 类 号：R511[医药卫生—内科学]