成都市新冠出院病例复查核酸阳性的影响因素分析  

Analysis on the influencing factors for re-positive nucleic acid test result in discharged COVID-19 patients in Chengdu

作　　者：毛毅 庹晓莉 陈红[4] 杨铭 张仁卿 蒋良双 岳勇 蒲萍 刘良茜[1] 姜晓曼 MAO Yi;TUO Xiaoli;CHEN Hong;YANG Ming;ZHANG Renqing;JIANG Liangshuang;YUE Yong;PU Ping;LIU Liangqian;JIANG Xiaoman(Emergency Department,Chengdu Public Health Clinical Medical Center,Chengdu,610061,P.R.China;Chengdu Workstation of Emerging Infectious Diseases,Chinese Academy of Medical Sciences,Chengdu,610000,P.R.China;Chengdu Center for Disease Control and Prevention,Chengdu,610000,P.R.China;Department of Critical Care,Chengdu Public Health Clinical Medical Center,Chengdu,610061,P.R.China;Tuberculosis Department,Chengdu Public Health Clinical Medical Center,Chengdu,610061,P.R.China)

机构地区：[1]成都市公共卫生临床医疗中心应急科,成都610061 [2]中国医学科学院成都新发突发传染病防治工作站,成都610000 [3]成都市疾病预防控制中心,成都610000 [4]成都市公共卫生临床医疗中心重症医学科,成都610061 [5]成都市公共卫生临床医疗中心结核科,成都610061

出　　处：《中国胸心血管外科临床杂志》2023年第2期173-178,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省科技厅新冠肺炎疫情常态化关键技术研究(2021YFS001);中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2020-PT330-005)。

摘　　要：目的分析四川省成都市新型冠状病毒(新冠)感染出院患者复阳的影响因素,为新冠感染疫情防控提供数据支持。方法回顾性分析2020年1月23日—2021年2月28日成都市公共卫生临床医疗中心660例新冠感染出院患者的临床资料,根据病毒核酸检测结果,将出院患者分为未复阳组[549例,其中男428例、女121例,中位年龄33.0(28.0,48.0)岁]和复阳组[111例,其中男76例、女35例,中位年龄39.0(28.0,51.0)岁],比较两组患者的临床资料。结果全组患者复阳率16.82%。单因素分析显示:女性复阳率高于男性(χ^(2)=4.608,P=0.032)。确诊患者复阳率高于无症状感染者(χ^(2)=8.140,P=0.004)。境内患者复阳率高于境外输入患者(χ^(2)=9.178,P=0.002)。未复阳组CD3^(+)T淋巴细胞(P=0.038)、CD4^(+)T淋巴细胞(P=0.048)、CD8^(+)T淋巴细胞(P=0.040)计数高于复阳组。二元logistic回归分析结果显示:新冠感染患者临床分型、CD8^(+)T淋巴细胞计数与复阳之间存在显著相关性(P<0.05),是复阳的独立危险因素。结论新冠感染患者的性别、来源地、T淋巴细胞亚群计数、临床分型是复阳的影响因素,而临床分型以及CD8^(+)T淋巴细胞计数是复阳的独立危险因素。提高新冠感染患者的免疫力,以及早期发现和及时治疗是减少复阳发生的有效手段。Objective To analyze the influencing factors for re-positive nucleic acid test in discharged coronavirus disease 2019(COVID-19)patients in Chengdu,Sichuan Province,and to provide data support for the epidemics prevention and control.Methods The clinical data of 660 discharged COVID-19 patients from January 23,2020 to February 28,2021 in our center were retrospectively analyzed.The patients were divided into two groups according to the reexamination of virus nucleic acid,including a negative group[549 patients,including 428 males and 121 females with a median age of 33.0(28.0,48.0)years]and a positive group[111 patients,including 76 males and 35 females with a median age of 39.0(28.0,51.0)years].The clinical data of the two groups were compared.Results The re-positive rate of the discharged patients was 16.82%.Univariate analysis showed that the re-positive rate of females was higher than that of males(χ~2=4.608,P=0.032).The re-positive rate of confirmed patients was higher than that of asymptomatic infected patients(χ~2=8.140,P=0.004).The re-positive rate of domestic patients was higher than that of imported patients(χ~2=9.178P=0.002).The counts of CD3^(+)(P=0.038),CD4^(+)(P=0.048)and CD8^(+)(P=0.040)T lymphocytes in the negative group were higher than those in the positive group.The binary logistic regression analysis showed that the clinical classification and CD8^(+)T lymphocyte count were independent risk factors affecting the recurrence of virility.Conclusion The gender origin,T lymphocyte subsets count and clinical type are the influencing factors for re-positive result,and clinical type and CD8^(+)T lymphocyte count are the independent influencing factors for re-positive result.Therefore,improving the immunity of infected patients,as well as early detection and timely treatment are effective means to reduce the re-positive occurrence.

关 键 词：新型冠状病毒感染 核酸检测 复阳 出院患者 影响因素 

分 类 号：R563.1[医药卫生—呼吸系统]