新型冠状病毒肺炎患者核酸转阴时间的影响因素分析  

Influencing factors of negative conversion time of nucleic acid in patients with corona virus disease 2019

作　　者：史丽霞[1] 韩晶[2] 张永进[2] 付莎莎[1] 王合荣[1] 黄淑萍 SHI Lixia;HAN Jing;ZHANG Yongjin;FU Shasha;WANG Herong;HUANG Shuping(Department of Respiratory Medicine,Tianjin Haihe Hospital,Tianjin 300350,China;不详)

机构地区：[1]天津市海河医院呼吸科,天津300350 [2]天津市海河医院医务科,天津300350 [3]天津市呼吸疾病研究所

出　　处：《上海医学》2021年第8期576-579,共4页Shanghai Medical Journal

基　　金：天津市卫生健康科技项目(2020xkc03)。

摘　　要：目的探讨新型冠状病毒肺炎(COVID-19)的核酸转阴时间及其影响因素。方法收集2020年1月21日-5月13日在天津市海河医院治疗的190例COVID-19患者的流行病学与临床资料。对确诊患者的核酸转阴情况、可能影响核酸转阴的相关因素行单因素与多因素分析。结果治疗期间核酸转阴患者187例,3例死亡。患者核酸转阴的时间为(17.03±8.33)d,转阴时间范围为3~51 d。70.6%(132/187)的患者核酸转阴时间≤21 d。低白蛋白血症、临床分型为重型、合并感染、就诊时有症状、接受激素或胸腺肽治疗、热程>4 d、就诊延误时间>5 d、乳酸脱氢酶(LDH)或CRP水平升高为患者治疗期间影响核酸转阴时间的风险因素(P值均<0.05)。低白蛋白血症、就诊时有症状、热程>4 d是患者治疗期间核酸转阴时间延长的独立危险因素(P值均<0.05)。结论就诊时患者有症状、热程>4 d、低白蛋白血症与COVID-19患者核酸转阴时间延长显著相关。对于该类患者,应严密观察,适当延长隔离时间。Objective To explore the negative conversion time of nucleic acid in patients with corona virus disease 2019(COVID-19)and its influencing factors.Methods Epidemiological and clinical data of 190 patients with COVID-19 treated in our hospital between January 21,2020 and May 13,2020 were collected.Univariate and multivariate analysis were used to analyze the factors related to negative conversion of nucleic acid.Results Among these patients,187 patients gained negative conversion of nucleic acid and 3 died.The mean duration of negative conversion was(17.03±8.33)d(range,3-51 d).We found that 70.6%(132/187)patients had nucleic acid negative conversion time≤21 d.There were statistically significant differences in ten factors,including hypoalbuminemia,high-risk clinical classification,concurrent infection,symptomatic condition at visit,hormone therapy,thymosin therapy,fever course>4 d,delay in treatment>5 d,abnormally increased lactate dehydrogenase(LDH)and C-reactive protein(CRP,all P<0.05).Multivariate Cox regression analysis showed that hypoalbuminemia,symptomatic condition at visit and fever course>4 d were independent risk factors of prolonged virus shedding time(all P<0.05).Conclusion Symptomatic condition at visit,fever course>4 d and hypoalbuminemia are significantly related to the negative conversion time of nucleic acid in patients with COVID-19.These patients should be closely observed and the isolation time should be prolonged appropriately.

关 键 词：新型冠状病毒 肺炎 核酸转阴时间 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]