摘要
目的探讨新型冠状病毒肺炎(COVID-19)临床表现及高分辨率CT(HRCT)影像分型和影像演变特征的临床意义。方法回顾性分析2020年1月20日至2月8日武汉大学人民医院确诊的141例COVID-19患者的临床特征、病毒核酸检测结果和HRCT影像学分型及影像演变特征。结果141例COVID-19患者首诊实验室检查发现白细胞计数及淋巴细胞比率降低。141例COVID-19患者中临床表现以发热最为常见(>37.5℃)139例(98.58%),偶见呼吸道以外症状如腹泻4例(2.84%)。141例COVID-19患者HRCT均有异常,52例(36.88%)胸部HRCT图像表现为磨玻璃影(GGO),以胸膜下分布为主;23例(16.31%)GGO合并局灶实变影;27例(19.15%)呈小片状模糊影;20例(14.18%)呈大片状实变影;48例(34.04%)可见支气管血管束增粗和血管穿行征;5例(3.55%)有空气支气管征;7例(4.96%)有小结节影;5例(3.55%)呈纤维化、网格影或条索影。首次核酸检测阳性者135例(95.74%),阴性者6例(4.26%),同期HRCT结果普通型71例(50.35%)、重型47例(33.33%)和危重型23例(16.31%),各型自起病至首次CT检查平均时间分别为(2.51±1.32)、(5.02±2.01)、(5.91±1.76)d;其中首次检查为重型的病例有19例(19/47,40.43%)在第二次检查时病变分型加重、第三次检查时分型减轻。第二次核酸检查阳性者141例(100%),同期HRCT结果为普通型44例(31.21%)、重型53例(37.59%)和危重型44例(31.21%),各型距离首次CT检查平均间隔时间分别为(3.32±1.61)、(3.93±1.84)和(4.15±1.57)d。第三次核酸检查阳性者113例,阴性者28例,同期HRCT结果为普通型79例(56.03%)、重型46例(32.62%)和危重型16例(11.35%),各型距离首次CT检查平均间隔时间分别为:(5.59±1.83)、(7.32±1.37)、(7.55±1.78)d;不同时间节点CT检查影像分型的差异均具有统计学意义(P<0.05)。结论COVID-19的临床特征及HRCT影像表现多样,双肺广泛的GGO、浸润影为其典型表现;病毒核酸检测阳性通常早于或与CT阳性同步出现,�
Objective To investigate the clinical manifestations of the clinical characteristics of 141 patients with coronavirus disease 2019(COVID-19)and the imaging evolution characteristics of High Resolution CT(HRCT)in the chest.Methods From January 20,2020 to February 8,141 COVID-19 patients in Renmin Hospital of Wuhan University,77 males and 64 females,with a median age of 49(9,87),were retrospectively analyzed.The clinical features,laboratory examination indexes and HRCT evolution findings of 141 COVID-19 patients were analyzed.Results Laboratory examinations of 141 COVID-19 patients showed a decrease in white blood cell count and lymphocyte ratio.Among the 141 patients with COVID-19,fever(>37.5℃)was the most common clinical manifestation in 139 cases(98.58%),and occasionally non-respiratory symptoms such as diarrhea in 4 cases(2.84%).141 patients with COVID-19 had abnormal HRCT.52(36.88%)chest HRCT images showed ground-glass opacity(GGO),mainly under pleural;23(16.31%)GGO with focal consolidation;27(19.15%)small flaky shadows;20 cases(14.18%)large flaky consolidation shadows;48 cases(34.04%)bronchovascular bundle thickening and vascular penetrating signs;5 cases(3.55%)had air bronchial signs;7 cases(4.96%)of small nodule shadows;5 cases(3.55%)of fibrosis,grid shadows or strand shadows.135 cases(95.74%)were positive for the first time nucleic acid test,6 cases(4.26%)were negative,and 71 cases(50.35%)of common type,47 cases(33.33%)of severe type and 23 cases(16.31%)of critical type were found during the same period.The average time from onset of each type to the first CT examination was:(2.51±1.32),(5.02±2.01),and(5.91±1.76)days;19(19/47,40.43%)of which were severe for the first time CT classification worsened at the second examination and lessened at the third examination.141 cases(100%)were positive for the second nucleic acid test,and the HRCT results for the same period were 44 cases(31.21%)of common type,53 cases(37.59%)of severe type,and 44 cases(31.21%)of critical type;the average interval time was(3.32±1
作者
陆雪芳
龚威
王莉
李亮
谢宝君
彭宙锋
查云飞
Lu Xuefang;Gong Wei;Wang Li;Li Liang;Xie Baojun;Peng Zhoufeng;Zha Yunfei(Department of Radiology,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2020年第6期509-515,共7页
Chinese Journal of Tuberculosis and Respiratory Diseases