上海市长宁区新型冠状病毒肺炎确诊与疑似未确诊病例的比较研究  

Comparative study of confirmed and suspected undiagnosed cases of COVID-19 in Changning District,Shanghai

作　　者：高慧 顾佳玲 赵文穗[1] 汤泓[1] 夏仪[1] 赵根明[2] 蔡恩茂[1] 庄建林[1] GAO Hui;GU Jia-ling;ZHAO Wen-sui;TANG Hong;XIA Yi;ZHAO Gen-ming;CAI En-mao;ZHUANG Jian-lin(Changning Center for Disease Control and Prevention,Shanghai 200051,China;School of Public Health,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市长宁区疾病预防控制中心,上海200051 [2]复旦大学公共卫生学院,上海200032

出　　处：《上海预防医学》2021年第5期453-457,462,共6页Shanghai Journal of Preventive Medicine

摘　　要：【目的】分析上海市长宁区新型冠状病毒肺炎确诊与疑似未确诊病例的流行病学资料和临床指标之间的差异,为尽早发现确诊病例提供科学依据。【方法】采用回顾性比较研究的方式,收集2020年1月15日至2月25日长宁区各发热定点医疗门诊报告发现的20例新型冠状病毒肺炎确诊病例和同期报告的34例疑似未确诊病例(后新型冠状病毒核酸检测阴性),比较两组人群流行病学史、早期临床症状、血常规指标和影像学特征的差异。【结果】该区的新型冠状病毒肺炎疫情以输入性为主。确诊病例和疑似未确诊病例早期多表现为发热、干咳等呼吸道症状。相较于疑似未确诊病例,确诊病例的白细胞、嗜酸性粒细胞、嗜碱性粒细胞、中性粒细胞的细胞计数存在显著性差异(P<0.01),确诊病例的C‑反应蛋白浓度也略低(P=0.230)。确诊病例的影像学主要为两肺散在分布的磨玻璃影,疑似未确诊病例则主要表现为单纯斑片影,而磨玻璃影分布较为不规律。【结论】确诊病例与疑似未确诊病例在流行病学史、血常规指标和肺影像学特征上存在明显差异。[Objective]To analyze and compare the differences between the epidemiological data and clinical indicators of confirmed and suspected undiagnosed cases of COVID-19 in Changning District,Shanghai.[Methods]A retrospective comparative study was conducted.We included 20 confirmed and 34 suspected but undiagnosed COVID-19 cases from January 20 to February 29,2020.We analyzed the differences in epidemiological history,early clinical symptoms,blood routine indicators,and clinical imaging characteristics between the two groups.[Results]The epidemic status of COVID-19 in Changning District of Shanghai was mainly imported,and most cases were promptly confirmed.Early clinical symptoms of confirmed and suspected undiagnosed cases often manifested as respiratory symptoms such as fever and dry cough.Compared with the confirmed cases,the cell counts of leukocytes,eosinophils,and neutrophils in suspected undiagnosed cases were significantly higher.Also,the concentration of serum C-reactive protein in suspected cases was higher than that in confirmed cases(P=0.230).The clinical imaging manifestations of confirmed cases were mainly ground glass opacity(GGO)scattered in both lung leaves,while the suspected undiagnosed cases mainly manifested as plain patch opacity,and the distribution of GGO was more irregular.[Conclusion]There exists significant difference in blood routine indicators and clinical imaging features between confirmed and suspected cases of COVID-19.

关 键 词：新型冠状病毒肺炎 疑似病例 比较研究 临床症状 

分 类 号：R511[医药卫生—内科学]