成都市新型冠状病毒肺炎康复期患者出院后2年实验室及影像学检查复诊结果分析  

Analysis of laboratory and imaging examination results of patients with COVID-192 years after discharge in Chengdu

作　　者：赵本南 杜清 康俊 刘大凤 张玲 兰丽娟 袁媛[2] ZHAO Ben-nan;DU Qing;KANG Jun;LIU Da-feng;ZHANG Ling;LAN Li-juan;YUAN Yuan(Department of Comprehensive Internal Medicine,Public Health Clinical Center of Chengdu,Chengdu 610061,China;Department of Infectious Diseases,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610513,China)

机构地区：[1]成都市公共卫生临床医疗中心内科,四川成都610061 [2]成都医学院第一附属医院感染科,四川成都610513

出　　处：《海南医学院学报》2022年第17期1281-1287,共7页Journal of Hainan Medical University

基　　金：成都市高水平临床重点专科建设项目-传染病学专项;成都市卫生健康委员会项目(2021250);成都市科技局项目(2021-YF05-00536-SN)。

摘　　要：目的:总结成都市新型冠状病毒肺炎(简称新冠肺炎)患者出院后2年实验室检查、心脏彩超及胸部CT复诊结果。方法:收集治愈出院后1、2年均到成都市公共卫生临床医疗中心复诊的29例新冠肺炎既往感染者的血实验室检查、心脏彩超及胸部高分辨率CT结果,使用统计学软件分析各指标的变化,为评估新冠肺炎既往感染者远期恢复情况提供参考。结果:出院后2年异常血实验室检查结果主要表现为血清纤维结合蛋白升高(72.4%)及NK细胞计数降低(65.5%);与出院后1年比较,血小板计数、羟丁酸脱氢酶、肌酸激酶同工酶降低,血清纤维结合蛋白、甘油三酯、胰岛素、非特异性免疫球蛋白A升高,差异均具有统计学意义(P<0.05)。既往感染者接种新冠病毒疫苗后半年,血清特异性总抗体结果明显高于接种前。超半数(55.2%)复诊者心脏彩超结果正常,异常结果主要为瓣膜轻度反流(24.1%)及左室舒张功能降低(31.0%);与出院后1年比较,有7例(24.1%)心脏彩超异常结果减少。28例出院后2年复查胸部CT,异常结果主要为磨玻璃影(17.9%)、肺小结节(直径<6 mm)(32.1%)及散在索条影(39.3%),71.4%(20/28)的随访者两次胸CT结果无明显变化。结论:新冠肺炎康复者出院后2年的异常血实验室指标主要为血清纤维结合蛋白升高及NK细胞计数降低。虽然大部分患者心脏彩超及胸部CT与1年前比较无明显变化,仍有部分患者异常结果在减少。新冠肺炎既往感染者接种新冠灭活疫苗后半年总抗体仍显著高于接种前,但特异性抗体水平随时间推移呈下降趋势。Objective:To summarize the follow-up results of laboratory examination,echocardiographic and chest CT of patients with COVID-19 at the time of 2 years after discharge in Chengdu.Methods:A total of 29 COVID-19 survivors who have participated in the 1-year follow-up and 2-year follow-up at Public Health Clinical Center of Chengdu were included in our study.Their blood laboratory tests,echocardiography and chest CT results were analyzed in order to evaluate the long-term recovery of COVID-19 survivors.Results:The most common abnormal laboratory test results at the 2-year follow-up were increased serum fibronectin(21 cases,72.4%)and decreased NK cell counts(19 cases,65.5%).Compared with laboratory test results at the1-year follow-up,platelet count,hydroxybutyrate dehydrogenase and creatine kinase isoenzyme were decreased(all P<0.05),while serum fibrinogen,triglyceride,insulin and non-specific immunoglobulin A were increased(all P<0.05).Serum specific total SARS-CoV-2 antibody amount in COVID-19 survivors at half a year after COVID-19 vaccine was significantly higher than that before vaccination.More than half of patients(55.2%)had normal echocardiography results at the 2-year follow-up,the main abnormal results of them were valve regurgitation(7 cases,24.1%)and reduced left ventricular diastolic function(9 cases,31.0%).Compared with 1-year follow-up,7 patients had fewer abnormal cardiac ultrasound results.28 cases underwent chest CT at the2-year follow-up,the mainly abnormal results were ground glass shadow(17.9%),pulmonary nodules(diameter<6mm)(32.1%)and scattered cable shadow(39.3%).71.4%(20/28)of them had no significant change between the two chest CT results.Conclusion:The mainly abnormal blood laboratory indicators in COVID-19 survivors at 2-year follow-up after discharge were increased serum fibronectin and decreased NK cell counts.Although echocardiography and chest CT results were no significant change between 1-year follow-up and 2-year follow-up among COVID-19 survivors,there were still some patients whose

关 键 词：新型冠状病毒肺炎 新型冠状病毒 复诊 实验室检查 疫苗接种 

分 类 号：R563.1[医药卫生—呼吸系统]