摘要
目的分析新型冠状病毒肺炎(COVID-19)患者不同病情状态下淋巴细胞、白细胞介素-6(IL-6)及炎症指标的变化。方法选取2020年1月28日—2020年2月21日重庆三峡中心医院收治的74例COVID-19患者,包括27例重症患者、18例危重症患者和29例轻症患者。根据不同病情状态将抽取的74例COVID-19患者分为5组,其中重症及危重症患者分为A、B、C、D组,轻症为E组,部分患者因病情进展会多次统计。采用流式细胞分析仪及血常规分析仪分别检测患者不同病情状态下的淋巴细胞、IL-6及炎症指标的水平。结果不同程度的重症患者的IL-6与C反应蛋白(CRP)水平均显著高于轻症患者(P<0.01),且A组患者[行气管插管、体外膜肺氧合(ECMO)及死亡前患者]的IL-6水平均显著高于其他4组患者(P<0.05);呼吸困难越严重的患者,其淋巴细胞计数、T淋巴细胞、B淋巴细胞、CD4^+T、CD8^+T水平越低,且不同程度重症患者与轻症患者均有显著差异(P<0.05);呼吸困难症状越严重的患者,其淋巴细胞比率越低,且A组患者与其他组患者相比有显著差异(P<0.01);5组患者降钙素原(PCT)指标无显著差异(P>0.05)。结论IL-6、淋巴细胞、CRP指标能预测新型冠状病毒肺炎患者的病情变化。
Objective To analyze the changes of lymphocyte,interleukin-6(IL-6)and inflammatory indexes in patients with coronavirus disease 2019(COVID-19)under different conditions of disease in northeast division of Chongqing.Methods A total of 74 patients with COVID-19 in Chongqing Three Gorges Central Hospital from January 28,2020 to February 21,2020 were selected,which including 27 severe cases,18 critical cases and 29 mild cases.They were divided into five groups according to theirdisease status,among whom the critically ill patients were divided into groups A,B,C and D,and the mild ill patients into group E.Some patients were counted several times due to disease progression.Flow cytometer and blood routine analyzer were used to detect the levels of lymphocyte,IL-6 and inflammatory indexes in patients with different conditions of disease.Results The levels of IL-6 and C reactive protein(CRP)in severe patients with different conditions of disease were significantly higher than those in mild patients(P<0.01),and the level of IL-6 in group A[patients with endotracheal intubation,extracorporeal membrane oxygenation(ECMO)and pre-death status]was significantly higher than that in the other four groups(P<0.05).The more severe the dyspnea was,the lower the lymphocyte count,T-lymphocyte,B-lymphocyte,CD^4+T and CD8^+T levels were,and there were significant differences between severe patients with different conditions and mild patients(P<0.05).The more severe the dyspnea symptom was,the lower the lymphocyte ratio was,and there was a significant difference between group A and other groups(P<0.01).There was no significant difference in procalcitonin among five groups(P>0.05).Conclusion IL-6,lymphocyte and CRP can predict the change of coronavirus disease 2019.
作者
靳云洲
李明芳
郑胜
张吉琴
屈云飞
张俭荣
JIN Yunzhou;LI Mingfang;ZHENG Sheng;ZHANG Jiqin;QU Yunfei;ZHANG Jianrong(Department of Cardiovascular Surgery,Chongqing Three Gorges Center Hospital,Chongqing,404100;Chongqing Three Gorges Medical College,Chongqing,404100;Department of Trauma Surgery,Chongqing Three Gorges Center Hospital,Chongqing,404100)
出处
《实用临床医药杂志》
CAS
2020年第6期1-4,共4页
Journal of Clinical Medicine in Practice
基金
重庆市万州区第一批新冠肺炎防控应急科技攻关专项项目(2020008,2020001)
重庆市万州区科技计划资助项目(wzstc-2019044)
重庆市科卫联合重点第一批新冠肺炎防控应急科研专项(No2020NCPZX07)。
