摘要
目的:分析白细胞增高的新型冠状病毒肺炎(COVID-19)的临床特征,探讨患者血清炎性指标与病情严重程度的关系。方法:选取2020年1月31日至2020年2月14日武汉大学人民医院东院区隔离病房收治的白细胞增高的COVID-19患者为研究对象,收集临床资料,分析一般情况、临床症状和血液检验。根据相关诊断标准将患者分为普通型(9例)、重型(62例)和危重型(39例)3组;根据是否首次检测外周血白细胞增高分为首次白细胞增高组和非首次白细胞增高组。检测各组患者外周血炎症相关标志物水平,分析和比较各组外周血炎症相关标志物各指标变化的规律及其与疾病临床分型的关系。结果:①本研究共纳入白细胞增高的COVID-19患者110例,男性多见,重症、危重症高龄多见,危重症死亡率高。②将患者按病情危重程度分普通型、重型、危重型,发现重型及危重型患者白细胞、乳酸脱氢酶(LDH)、C反应蛋白(CRP)数值均高于普通型(P<0.05),淋巴细胞比例低于普通型患者(P<0.05),PCT(降钙素原)变化不明显;危重型患者年龄高于重型患者,LDH、中性粒细胞比例、CRP数值均高于重型患者(P<0.05),淋巴细胞比例低于普通患者(P<0.05),PCT变化不明显;③比较首次白和非首次白细胞增高两组患者资料,发现首次血常规白细胞增高组患者年龄大、基础疾病多、危重比例高、死亡率高(P<0.05),且LDH、中性粒比值、CRP、PCT较非首次白细胞增高组高,淋巴细胞比值低,表达水平差异均具有统计学意义(P<0.05)。结论:白细胞增高的COVID-19患者病情较重;入院首次白细胞增高的COVID-19患者重型和危重型多见,死亡率高;白细胞增高的COVID-19患者多合并细菌感染,对临床治疗有一定指导意义。
Objective:To analyze the clinical features of coronavrius disease 2019(COVID-19)with leuko-cytosis,and to explore the relationship between serum inflammatory parameters and severity of the disease.Methods:COVID-19 patients with increased white blood cells(WBC)in the Renmin Hospi-tal of Wuhan University from January 31,2020 to February 14,2020 were selected as the research ob-jects to collect the clinical data,such as general conditions,clinical symptoms,and blood tests.Pa-tients were divided into three groups according to the relevant diagnostic criteria:normal type(9 cas-es),severe type(62 cases),and critical type(39 cases).Furthermore,the patients were divided into two groups according to whether the WBC counts were increased for the first time or not.The levels of inflammation-related markers in each group were detected,and the relationship between the levels of inflammation-related markers and clinical types of diseases was analyzed and compared.Results:There were 110 cases of COVID-19 patients with leukocytosis,most of them were male patients or severe and critically elderly patients,and moreover,the mortality rate was high in critical cases.In the severe type and critical type patients,the levels of WBC,lactate dehydrogenase(LDH)and CRP were higher than in the normal type patients(P<0.05),while the proportion of lymphocyte was lower(P<0.05).In the critical type patients,the LDH,the proportion of neutrocyte,and CRP levels were higher than in the severe type(P<0.05).The proportion of lymphocyte of critical type was low-er than that of the normal type(P<0.05).And no significant difference was found in procalcitonin(PCT)levels between different type groups.When comparing between the first-time leukocytosis and non-first-time leukocytosis in COVID-19 patients,we found that the patients in the first-time leukocy-tosis group,the age,basic diseases,proportion of critical mass,mortality,the expression of LDH,neutrophil ratio,CRP and PCT were significantly higher than those in non-first-time leukocytosis group(P<0.05
作者
李瑞云
聂汉祥
吴小军
LI Ruiyun;NIE Hanxiang;WU Xiaojun(Dept.of Respiratory and Critical Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第5期697-701,共5页
Medical Journal of Wuhan University
关键词
新型冠状病毒肺炎
白细胞
临床特征
Coronavrius Disease 2019(COVID-19)
Leukocyte
Clinical Features
