新型冠状病毒感染者咽拭子与粪便排毒规律及临床表现  

The Regularity and Clinical Manifestations of Throat Swab and Fecal Detoxification in New Coronavirus Infected Patients

作　　者：黄瑛 罗云 武彦 刘冰 江姗 何花 HUANG Ying;LUO Yun;WU Yan;LIU Bing;JIANG Shan;HE Hua(Dept.of Infectious Diseases,Kunming Third People’s Hospital,Kunming Yunnan 650041;School of Public Health,Dali University,Dali Yunnan 671000,China)

机构地区：[1]昆明市第三人民医院感染性疾病科,云南昆明650041 [2]大理大学公共卫生学院,云南大理671000

出　　处：《昆明医科大学学报》2022年第1期96-101,共6页Journal of Kunming Medical University

基　　金：昆明市科技局科研基金资助项目(2020-1-C-004)。

摘　　要：目的通过分析咽拭子、粪便新冠病毒核酸均阳性者的临床表现,探索其临床特征及排毒规律,为临床诊疗提供依据。方法回顾性分析昆明市第三人民医院2020年2月至12月收治的59例新冠病毒感染者临床症状、实验室指标、咽拭子及粪便新冠病毒排毒规律。结果粪便阳性组:潜伏感染7例,首次咽拭子核酸阳性至有症状3~8 d(中位数4 d),持续阳性5例,反复阳性2例;咽拭子阳性后1~28 d粪便呈阳性(中位数6 d)。无症状5例,咽拭子持续阳性2例,反复阳性2例;咽拭子阳性后4~21 d粪便呈阳性(中位数6 d)。21例有症状者发病至咽拭子阳性1~21 d(中位数5 d),8例持续阳性4~20 d,10例反复阳性8~26 d;咽拭子阳性后4~29 d粪便呈阳性(中位数15 d)。粪便阴性组:潜伏感染6例,咽拭子阳性至有症状4~10 d(中位数5 d),持续阳性2例、反复阳性2例;4例无症状者咽拭子持续阳性1例、反复阳性1例;16例有症状者发病至咽拭子阳性1~16 d(中位数5.5 d),持续阳性3例、反复阳性10例。2组咽拭子核酸持续阳性时间有统计学差异(P<0.05)、反复阳性时间无统计学差异(P>0.05);2组肺部CT表现有统计学差异(P<0.05);2组临床表现、肝功、肾功、心肌酶、血常规、CRP、T淋巴细胞等均无统计学差异(P>0.05)。结论2组症状体征、脏器功能损伤、炎症指标均无差异。病毒排毒规律性不强,但咽拭子及粪便均排毒者比仅咽拭子排毒者排毒持续时间更长,肺炎更多见。Objective To explor the clinical characteristics and detoxification rules of the patients with COVID-19 nucleic acid positive by analyzing their clinical manifestations of throat swabs and fecal,so as to provide the evidence for the clinical diagnosis and treatment.Methods The clinical symptoms,laboratory indexes,and the detoxification of throat swab and faecal in 59 patients with COVID-19 infection admitted to Kunming Third People’s Hospital from February 2020 to December were retrospectively analyzed.Result Fecal positive group:In 7 cases of latent infection,the first pharyngeal swab nucleic acid was positive to symptomatic for 3~8 days(median 4 days),5 cases were continuously positive and 2 cases were repeatedly positive;The stool was positive1~28 days after the pharyngeal swab was positive(median 6 days).5 cases were asymptomatic,2 cases were continuously positive and 2 cases were repeatedly positive;The stool was positive 4~21 days after the pharyngeal swab was positive(median 6 days).21 symptomatic patients were positive for pharyngeal swab for 1~21 days(median 5 days),8 cases were continuously positive for 4~20 days,and 10 cases were repeatedly positive for8~26 days;The stool was positive 4~29 days after the pharyngeal swab was positive(median 15 days).Fecal negative group:In 6 cases of latent infection,pharyngeal swabs were positive to symptomatic for 4~10 days(median 5 days),2 cases were continuously positive and 2 cases were repeatedly positive;In 4 asymptomatic patients,pharyngeal swabs were continuously positive in 1 case and repeatedly positive in 1 case;In 16 symptomatic patients,the pharyngeal swab was positive for 1~16 days(median 5.5 days),3 cases were continuously positive and 10 cases were repeatedly positive.There was significant difference in the continuous positive time of the pharyngeal swab nucleic acid between the two groups(P<0.05),and there was no significant difference in the repeated positive time(P>0.05);There was significant difference in CT findings between the two groups(P<0.05)

关 键 词：新型冠状病毒感染者 咽拭子 粪便 病毒核酸 

分 类 号：R563.1[医药卫生—呼吸系统]