宁夏回族自治区2019冠状病毒病75例临床特征及预后研究  

Clinical characteristics and outcomes of coronavirus disease 2019:analysis of 75 cases in Ningxia Hui Autonomous Region

作　　者：张淑香[1] 纳建荣[1] 高建梅 崔华[1] 周萍[2] 马国仁 周玮[1] ZHANG Shuxiang;NA Jianrong;GAO Jianmei;CUI Hua;ZHOU Ping;MA Guoren;ZHOU Wei(Department of Respiratory and Critical Care Medicine,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院呼吸与危重症医学科,银川750004 [2]宁夏医科大学总医院肺功能室,银川750004 [3]宁夏回族自治区第四人民医院呼吸内科

出　　处：《中国感染与化疗杂志》2021年第6期652-658,共7页Chinese Journal of Infection and Chemotherapy

基　　金：宁夏医科大学总医院新冠肺炎疫情防控应急项目(020007004028);2020年宁夏回族自治区重点研发计划科技支撑专项项目(2020BEG003004)。

摘　　要：目的分析75例2019冠状病毒病(COVID-19)患者的临床特征及近期预后,为疫情的防控提供依据。方法采用单中心回顾性研究方法,纳入2020年1月22日—3月16日宁夏回族自治区第四人民医院(传染病医院)隔离病房集中收治的75例COVID-19患者,在出院后2周、4周、2个月及6个月进行随访,分析临床特征、胸部影像学变化、肺功能、病毒核酸复阳、病毒特异性抗体产生等情况。采用SPSS 25.0统计软件进行统计学处理。结果75例患者中男42例,女33例,年龄3~77岁,平均(39.9±17.8)岁。本组患者轻型7例(9.3%)、普通型54例(72.0%)、重型12例(16.0%)、危重型2例(2.7%)。75例患者均治愈出院,治愈率100%。主要临床症状为发热(51/75,68.0%),咳嗽(60/75,80.0%),外周血多为白细胞总数正常或减低(72/75,96.0%),胸部高分辨率CT以双肺(39/68,57.4%)、多肺叶(43/68,63.2%)受累为常见。完成出院后2周、4周、2个月、6个月随诊人数分别为75例、75例、61例、51例,复诊人数逐渐减少。咳嗽、气短症状逐渐消失,胸部CT病灶逐渐吸收。出院2周病毒核酸复阳3例、4周病毒核酸复阳3例,疾病未复燃亦未造成再次传播。出院6个月肺功能正常者28例(28/48,58.3%)。11例(11/48,22.9%)不同程度的阻塞性通气功能障碍,3例(3/48,6.2%)不同程度的限制性通气功能障碍,13例(13/48,27.1%)不同程度的通气储备功能降低。特异性抗体IgG阳性30例(30/51,58.8%),IgM阳性14例(14/51,27.5%)。结论COVID-19患者整体预后良好,但治愈出院后4周内有少部分病毒核酸复阳;出院后6个月仍有部分患者肺内病灶未完全吸收、肺功能受损;出院后6个月近半数的患者IgG抗体阴性,提示存在再感染的可能;远期预后需要进一步观察。Objective To analyze the clinical characteristics and short term outcomes of coronavirus disease 2019(COVID-19)and to provide evidence for the prevention and control of the epidemic.Methods A single center retrospective study was conducted in 75 patients with COVID-19 who were admitted to the isolation ward of the Fourth People's Hospital of Ningxia Hui Autonomous Region from January 22 to March 16,2020.The patients were followed up for 2 weeks,4 weeks,2 months,and 6 months after discharge.The clinical characteristics,chest CT imaging,lung function,virus nucleic acid re-positivity and specific antibody production were analyzed.SPSS 25.0 software was used for statistical analysis.Results The 75 patients included 42 males and 33 females.The mean age of these patients was(39.9±17.8)(3-77)years old.Overall,7(9.3%)patients were mild cases,54(72.0%)moderate cases,12(16.0%)severe cases,and 2(2.7%)critical cases.All the 75(100%)patients were cured and discharged.The main symptoms were fever(51/75)and cough(60/75).Hematological tests showed normal or decreased leukocyte count(72/75).Chest high-resolution CT showed bilateral lung involvement(39/68,57.4%)and multiple lobes involvement(43/68,63.2%).After discharge,75,75,61 and 51 patients were followed up for 2 weeks,4 weeks,2 months,and 6 months,respectively.The symptoms of cough and shortness of breath gradually disappeared.The lesions on chest CT gradually absorbed.After discharge,nucleic acid test was positive again in 3 cases at 2 and 4 weeks.However,the positive nucleic acid tests did not cause spread of the disease.Six months after discharge,pulmonary function was normal in 28 cases(28/48,58.3%).Some degrees of obstructive ventilation dysfunction was found in 11 cases(11/48,22.9%).Some degrees of restrictive ventilation dysfunction was reported in 3 cases(3/48,6.2%).Decreased ventilation reserve function was found in 13 cases(13/48,27.1%).The prevalence of SARS-CoV-2-specific IgG and IgM antibodies was 58.8%(30/51)and 27.5%(14/51),respectively.Conclusions The overall

关 键 词：新型冠状病毒 临床特征 肺功能 复阳 预后 

分 类 号：R563.1[医药卫生—呼吸系统]