摘要
目的回顾新型冠状病毒肺炎(COVID-19)患者的临床特征和实验室指标,探讨重症危重症患者早期干预的临床价值。方法选取386例COVID-19确诊患者为研究对象,收集临床资料和实验室检测指标。分为普通组和重症危重症组。对两组患者临床特点和实验室指标进行比较及相关因素分析。结果两组基线资料结果比较显示:年龄比较差异有统计学意义(P<0.001);既往合并症中高血压比较差异有统计学意义(P<0.001)。两组临床症状中咳痰与气短比较,差异有统计学意义(P<0.05)。两组炎症指标、心肌酶学心衰指标及肝肾功能各项指标比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析比较:年龄、气短、乳酸脱氢酶、肌酐与病情危重程度呈正相关,白蛋白与病情危重程度呈负相关(P<0.05);其中气短的影响最大(OR=2.405)。乳酸脱氢酶ROC曲线图分析示:曲线下面积0.75,具有一定的诊断价值(P<0.001)。结论老年患者对新型冠状病毒更为易感,既往有高血压的患者,发病后更易恶化,合并肾脏和心脏衰竭的患者容易转为重症。应注意药物性肝损的情况发生。对于重症患者应注意防范自身免疫损伤和及时给与细菌感染的控制。重症患者LDH明显升高,建议将LDH水平作为评估COVID-19病毒感染病情程度的重要指标。
Objective To review the clinical features and laboratory indicators of patients with novel coro-navirus(COVID-19)pneumonia and to explore the clinical value of early intervention in critically ill patients.MethodsA total of 386 patients with COVID-19 were divided into normal group and severe and critical group andtheir clinical data and laboratory test indexes were collected and compared then the related factors were analyzed.ResultsComparison of baseline data between the two groups showed significant difference in terms of age(P <0.001)and hypertension(P < 0.001). As to clinical symptoms of the two groups,shortness of breath was statisti-cally significant(P < 0.05). Inflammation markers,indicators of myocardial enzymatic heart failure and liver andkidney function were significantly different between the two groups(P < 0.05). Logistic regression analysis showedthat age,shortness of breath,lactate dehydrogenase,and creatinine were positively correlated with the severity ofthe condition,but albumin was negatively with it(P < 0.05)and among them,the influence of shortness of breathwere the most severe(OR = 2.405). ROC of lactate dehydrogenase line diagram analysis showed that the areaunder the curve was 0.75,indicating a certain diagnostic accuracy(P < 0.001).ConclusionsElderly patientsare more susceptible to COVID-19 and patients with hypertension are more likely to deteriorate after the onset.Attention should be paid to the occurrence of drug-induced liver damage. For severe patients,more attention shouldgo to the prevention of autoimmune injury and timely control of bacterial infection. LDH significantly increasesin severe patients,and it is recommended that the LDH level be used as an important indicator to assess the severi-ty of COVID-19 infection.
作者
张磊
江巍
郑玉雯
严政
吴贝贝
李东升
熊晓昉
ZHANG Lei;JIANG Wei;ZHENG Yuwen;YAN Zheng;WU Beibei;LI Dongsheng;XIONG Xiaofang(Department of Cardiology,the Third Hospital of Wuhan,Wuhan 430060,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第14期1866-1871,共6页
The Journal of Practical Medicine
