新型冠状病毒肺炎合并胸腔积液及心包积液10例临床特征  

Clinical characteristics of COVID-19 complicated with pleural and pericardial effusion in 10 patients

作　　者：郭颖韵 张亮[2] 李瑞雪 田山[1] 董卫国[1] GUO Yingyun;ZHANG Liang;LI Ruixue;TIAN Shan;DONG Weiguo(Dept.of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Dept.of Radiology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Dept.of Gastroenterology,Renmin Hospital of Macheng,Huanggang 438300,Hubei,China)

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060 [2]武汉大学人民医院放射科,湖北武汉430060 [3]麻城市人民医院消化内科,湖北黄冈438300

出　　处：《武汉大学学报（医学版）》2021年第6期878-883,共6页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:81870392)。

摘　　要：目的:回顾性分析新型冠状病毒肺炎(COVID-19)合并胸腔积液及心包积液患者的临床特征。方法:收集2020年1月20日至3月23日武汉大学人民医院收治的COVID-19确诊患者的临床资料。分析其中10例合并胸腔积液和心包积液COVID-19患者的特点(积液组),并与50名无胸腔积液且无心包积液的COVID-19患者(对照组)进行对比。采用卡方检验、Fisher确切概率法和Mann-Whitney U进行统计学分析。结果:与对照组相比,积液组患者入院后最高体温(P<0.001)、胸闷症状发生率(P=0.024)、呼吸频率(P=0.004)的差异有统计学意义;生化指标中C-反应蛋白(P=0.039)和D-二聚体(P=0.038)均高于对照组;淋巴细胞(P=0.024)、血红蛋白(P=0.003)、CD4+T细胞(P=0.016)和氧饱和度(P=0.037)均显著低于对照组。积液组的疾病分型重,预后差,差异有统计学意义(P<0.05)。结论:合并胸腔积液和心包积液提示更严重的疾病分型及不良的预后,提示对于合并胸腔积液及心包积液的COVID-19患者应及时给予积极的支持治疗。Objective:To retrospectively analyze the clinical characteristics of corona virus disease 2019(COVID-19) patients with pleural and pericardial effusion.Methods:We retrospectively reviewed and compared data of 60 COVID-19 inpatients including 10 patients with pleural effusion(PLE) and pericardial effusion(PCE) and 50 cases without PLE/PCE,from January 20,2020 to March 23,2020 in Renmin Hospital of Wuhan University.The patients′ medical history,clinical features,physical findings,laboratory test results,and chest tomographic imaging were recorded and analyzed.Statistical significance was determined using the chi-square test,Fisher′s exact test,and the Mann-Whitney U-test.Results:COVID-19 patients with PLE and PCE had a higher temperature(P<0.001),a higher incidence of breath shortness(P=0.024) and faster respiratory frequency(P=0.004) than those without PLE and PCE.Laboratory findings showed that patients with PLE and PCE had higher levels of C-reactive protein(CRP,P=0.039) and D-dimer(P=0.038),and lower levels of lymphocytes(P=0.024),hemoglobin(P=0.003),CD4^(+)T cell counts(P=0.016),and oxygen saturation(P=0.037).Meanwhile,patients with PLE and PCE had higher incidence of severe or critical illness and mortality rates as compared with those without PLE and PCE(all P<0.05).Conclusion:PLE and PCE were indicators for severe inflammation and poor clinical outcomes,and might be independent risk factors for critical type in COVID-19 patients.It suggests that the treatment for the COVID-19 patients with PLE and PCE should be more active and timely.

关 键 词：新型冠状病毒肺炎 胸腔积液 心包积液 临床特征 

分 类 号：R512.99[医药卫生—内科学]