82例常德市新型冠状病毒肺炎患者的实验室指标分析  

Laboratory characteristics of 82 COVID-19 patients in Changde City

作　　者：仇玄 张瑶[1] 林立中[1] 朱志斌 王丽志 和珂莉 罗婷 邓小燕 吴建华[1] QIU Xuan;ZHANG Yao;LIN Lizhong;ZHU Zhibin;WANG Lizhi;HE Keli;LUO Ting;DENG Xiaoyan;WU Jianhua(Department of Clinical Laboratory,the First People's Hospital of Changde City,Changde,Hunan 415000,China;Department of Clinical Laboratory,the Second People's Hospital of Changde City,Changde,Hunan 415000,China;Department of Science and Education,rhe Second People's Hospital of Changde City,Changde,Hunan 415000,China;Department of Medical Administration,the Second People's Hospital of Changde City,Changde,Hunan 415000,China)

机构地区：[1]常德市第一人民医院检验科,湖南常德415000 [2]常德市第二人民医院检验科,湖南常德415000 [3]常德市第二人民医院科教科,湖南常德415000 [4]常德市第二人民医院医务科,湖南常德415000

出　　处：《中国医学工程》2022年第12期71-77,共7页China Medical Engineering

基　　金：常德市科技局新型冠状病毒感染的肺炎疫情应急专题项目(2020SK004)。

摘　　要：目的回顾性分析新型冠状病毒肺炎(COVID⁃19)患者首次入院的临床特征和相关实验室检测结果。方法收集2020年1月20日至2020年3月9日期间常德地区82例COVID⁃19患者首次入院时一般临床资料、患者入院后首次实验室检查结果,包括血常规、超敏C反应蛋白(CRP)、降钙素原(PCT)、血沉(ESR)、生化检查、凝血功能、D-二聚体等。将入组患者分为非重症组和重症组,比较两组之间实验室检查的差异,寻找新冠肺炎重症患者的危险因素。结果82例COVID-19患者中非重症患者60例、重症患者22例。首诊症状主要为发热(52例)、咳嗽(48例)、咳痰(12例)、乏力(20例)、厌食(11例)等。与非重症组相比,重症组血常规中的淋巴细胞计数显著降低,中性粒细胞与淋巴细胞比值(NLR)、CRP、ESR显著增加(P<0.05);重症组白蛋白显著减少,天冬氨酸转氨酶、肌酸激酶同工酶、D-二聚体显著增加(P<0.05)。NLR为分析新型冠状病毒肺炎重症的显著影响因素,即NLR每增加1个单位,患重症新型冠状病毒肺炎概率增加1.212(1.003,1.465)倍。NLR、ESR、PCT为联合预测重症新冠肺炎的最优模型,其AUC为0.767,灵敏度为66.7%,特异度为87.3%。结论COVID⁃19患者首次入院部分实验室指标出现特征性改变,且重症患者实验室指标改变也具有特异性,NLR、ESR、PCT可作为联合预测重症新冠肺炎的模型。本结果为新冠肺炎重症患者的早期识别和治疗方案的制定提供实验室参考依据。【Objective】To retrospectively analyze the clinical characteristics and related laboratory test results of first admission patients with coronavirus disease 2019(COVID-19).【Methods】This study enrolled 82 patients with COVID-19 who were treated in The Second People's Hospital of Changde City from January 20 to March 9,2020.The clinical data of patients after admission and laboratory tests results were collected such as blood routine,hypersensitive C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),biochemical examination,coagulation function,D-dimmer,etc.The enrolled patients were divided into the non-severe group and the severe group,and the differences in laboratory tests between the two groups were compared.【Results】There were 60 cases of non-severe patients and 22 cases of severe patients.The first symptoms were fever(52 cases),cough(48 cases),sputum(12 cases),fatigue(20 cases)and anorexia(11 cases).Compared with the non-severe group,the lymphocyte count in the severe group was significantly decreased,and the neutrophil/lymphocyte ratio(NLR),hypersensitive Creactive protein,erythrocyte sedimentation rate was significantly increased in the severe group(P<0.05).Albumin was significantly decreased and aspartate aminotransferase,creatine kinase isoenzyme,D-dimmer was significantly increased in the severe group(P<0.05).NLR was a significant influencing factor for the analysis of COVID-19 severe disease,the probability of COVID-19 severe disease was 1.212(1.003,1.465)higher for every 1 unit increase in NLR.NLR,ESR and PCT were the optimal combined prediction model of severe group,with AUC of 0.767,sensitivity of 66.7%and specificity of 87.3%.【Conclusion】During the first admission,the characteristic changes and laboratory indicators were observed in COVID-19 patients.NLR,ESR and PCT can be used as a combined prediction model of COVID-19 severe group.These results provide laboratory reference for the early diagnosis and treatment of COVID-19 patients.

关 键 词：新型冠状病毒肺炎 重症患者 临床症状 实验室检查 

分 类 号：R183[医药卫生—流行病学]