奥密克戎变异株新型冠状病毒感染患者舌象特征与核酸循环阈值等实验室指标的关系  

Relationship between tongue characteristics and laboratory indicators including nucleic acid cyclethreshold in Omicron variant COVID-19 patients

作　　者：李楠[1] 郑关毅[1] 林侃[1] LI Nan

机构地区：[1]福建医科大学附属协和医院,福建福州350001

出　　处：《中医临床研究》2024年第13期109-116,共8页Clinical Journal Of Chinese Medicine

基　　金：福建省“十四五”非中医医疗机构中医药科室建设项目(闽卫中医函[2023]344号)。

摘　　要：目的:探讨奥密克戎变异株新型冠状病毒感染(Corona Virus Disease 2019,COVID-19)普通型患者舌象特征与实验室指标的关系。方法:收集2022年4月-5月在上海城市足迹亚定点医院住院的165例临床确诊COVID-19普通型患者的舌象资料和实验室指标。舌象主要包括舌色、舌形、苔色、苔质。舌色分为淡红舌、淡白舌、红舌(包括绛舌)、青紫舌;舌形根据舌体形态分为正常舌、胖大舌(包括齿痕舌)、瘦薄舌;苔质根据舌苔厚薄程度分为薄苔、薄腻苔、厚腻苔,根据舌苔润燥程度分为润苔、燥苔;苔色分为白苔、黄苔。实验室指标包括核酸开放读码框基因(Open Reading Frame,ORF)和核壳蛋白基因(Nucleocapsid,N)的新冠病毒核酸循环阈(Cycle threshold,Ct)值、白细胞计数(White Blood Cell Count,WBC)、中性粒细胞/淋巴细胞值(Neutrophil/Lymphocyte Ratio,NLR)、C反应蛋白(C-reactive Protein,CRP)、降钙素原(Procalcitonin,PCT)、D-二聚体(D-dimer,DD)、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)、门冬氨酸氨基转移酶(Aspartate Ami-notransferase,AST)、白蛋白(Albumin,ALB)、乳酸脱氢酶(Lactate Dehydrogenase,LDH)、肌酐(Creatinine,Cr),并记录核酸阳性持续天数,分析不同舌象与上述指标的关系。结果:纳入的165例COVID-19普通型患者中淡红舌72例、淡白舌21例、红舌46例、青紫舌26例;正常舌69例、胖大舌64例、瘦薄舌32例;薄苔47例、薄腻苔33例、厚腻苔85例;润苔83例、燥苔82例;白苔88例、黄苔77例。淡白舌、红舌、青紫舌、胖大舌、瘦薄舌、燥苔患者核酸Ct值分别较淡红舌、正常舌、润苔患者降低(P<0.05);淡白舌、青紫舌、瘦薄舌、燥苔患者的核酸阳性持续时间与淡红舌、正常舌、润苔患者相比,分布有差异(P<0.05);胖大舌、瘦薄舌患者的CRP值高于正常舌患者(P<0.05);厚腻苔患者的PCT高于薄苔患者(P<0.05);厚腻苔、黄苔患者的NLR分别高于薄腻苔、薄苔、白苔�Objective:To explore the relationship between tongue manifestation and laboratory examination in patients infected with Corona Virus Disease 2019(COVID-19)omicron variant.Methods:Tongue images and laboratory indicators were collated from 165 patients with COVID-19 admitted to Shanghai Urban Footprint Sub designated Hospital between April to May 2022.Tongue color,shape,coating color and coating quality were analyzed.Tongue color included light red,light white,red and blue-purple.Tongue shape included normal,fat(including tooth marked)and thin according to the shape of the tongue.Coating quality included thin,thin putty and thick greasy,and moist/dry division was taken into account.Fur color was white or yellow.Laboratory indicators included COVID-19 nucleic acid cyclethreshold(Ct)value of ORF gene and N gene,white blood cell count(WBC),neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP),procalcitonin(PCT),D-dimer(DD),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),lactate dehydrogenase(LDH)and creatinine(Cr).Duration of nucleic acid positive status was recorded.Relationships between tongue images and the above indices were analyzed.Results:Among 165 patients,72 cases had a light red tongue,21 cases had a light white tongue,46 cases had a red tongue and 26 cases had a blue and purple tongue.There were 69 cases of a normal tongue shape,64 cases were fat and 32 cases were thin.There were 47 cases of thin fur,33 cases of thin greasy fur and 85 cases of thick greasy fur.In terms of moistening degree of tongue coating,there were 83 cases of moist and 82 cases of dry.A total of 88 patients had white fur,and 77 patients had yellow fur.Nucleic acid Ct values of patients with light white,red,blue purple,fat,thin and dry fur tongues were lower than those of patients with light red,normal and wet fur tongues(P<0.05).The duration of nucleic acid positive status of patients with pale white,blue purple,thin and dry fur tongues was different from those with pale red,normal and wet fur tongues(P<0.0

关 键 词：新型冠状病毒感染 舌质 舌苔 核酸循环阈值 核酸阳性持续时间 

分 类 号：R241.25[医药卫生—中医诊断学]