摘要
目的:探讨新型冠状病毒肺炎(COVID-19)患者的临床特征及外周血T淋巴细胞亚群的水平。方法:收集确诊的COVID-19患者(观察组)35例临床资料进行回顾性研究,对T淋巴细胞亚群数值及同期30例健康查体患者(对照组)的T淋巴细胞亚群的数值,进行统计学分析;依据新型冠状病毒肺炎诊疗方案(试行第六版)将病例分为普通组和重症组。结果:35例确诊患者中男性15例,女性20例,男女比3∶4;年龄21~82岁,≥50岁21例(60%),50岁以下14例(40%);合并高血压5例,糖尿病3例,冠心病1例,有明确接触史20例,占57.1%;发热为首发症状28例,占80%;咳嗽18例,占51.4%,多以干咳为主,4例咳少量白痰,1例咳多量黄痰;乏力16例,占45.7%;腹泻4例,占11.4%;肝功能异常15例,占42.9%;心肌酶异常2例,占5.7%;凝血四项异常3例,占5.3%。发病至入院平均5.54 d,3 d内入院14例(40%),7 d后入院13例(37.1%);平均住院天数为17.62 d;观察组血沉平均值57.66 mm/h,观察组C反应蛋白均值38.75 mg/L,二者较对照组均升高显著,差异具有统计学意义(P<0.05),而降钙素原均值0.087μg/L,与对照组相比,差异无统计学意义(P>0.05)。与对照组相比,观察组的淋巴细胞数值及白细胞计数下降显著,差异具有统计学意义(P<0.05),而淋巴细胞比例降低,差异无统计学意义(P>0.05),CD3^+、CD3^+CD4^+及CD4^+/CD8^+下降显著,差异具有统计学意义(P<0.05),而CD3^+CD8^+T淋巴细胞下降差异无统计学意义(P>0.05)。与普通组相比,重症组的CD3^+下降显著,差异具有统计学意义(P<0.05),而CD3^+CD4^+、CD3^+CD8^+、CD4^+/CD8^+T淋巴细胞下降,差异无统计学意义(P>0.05)。结论:COVID-19患者大多以发热为首发症状,多有明确接触史,实验室检查为血沉及C反应蛋白明显增高,降钙素原无明显变化,而外周血CD3^+、CD3^+CD4^+T淋巴细胞数量明显下降。CD3^+T淋巴细胞数值可作为早期预测COVID-19重型的指标,需重点监测和关注。
Objective:To investigate the clinical characteristics of patients with COVID-19 and the levels of T lymphocyte subsets in peripheral blood.Methods:The clinical data of 35 confirmed patients with COVID-19(observation group)were collected for retrospective study.The values of T lymphocyte subsets in the observation group and the control group(35 healthy patients at the same time)were statistically analyzed.According to the COVID-19 diagnosis and treatment plan(trial version 6),the cases were divided into ordinary group and severe group.Results:Among the 35 confirmed patients,there were 15 males and 20 females,and the male to female ratio was 3∶4;the age distribution was 21 to 82 years old,21 cases(60%)were≥50 years old,and 14 cases(40%)were under 50 years old;with hypertension(5 cases),diabetes(3 cases),coronary heart disease(1 case),with a clear history of exposure(20 cases),accounting for 57.1%;fever was the first symptom(28 cases),accounting for 80%;cough(18 cases),accounting for 51.4%,mostly dry cough,4 cases with a small amount of white sputum,1 case with a lot of yellow sputum;fatigue(16 cases),accounting for 45.7%;diarrhea(4 cases),accounting for 11.4%;abnormal liver function(15 cases),accounting for 42.9%;myocardial enzyme abnormalities(2 cases),accounting for 5.7%;four coagulation abnormalities(3 cases),accounting for 5.3%.The average time from onset to admission was 5.54 days,14 patients(40%)were admitted within 3 days,and 13 patients(37.1%)were admitted after 7 days;the average hospital stay was 17.62 days.The mean ESR was 57.66 mm/h,and the mean value of C reactive protein was 38.75 mg/L in the observation group,both of which were significantly higher than those in the control group(P<0.05).The mean value of procalcitonin was 0.087μg/L in the observation group,which was not statistically significant compared with that in the control group(P<0.05).Compared with the control group,the lymphocyte value and white blood cell count of the observation group decreased significantly(P<0.05);the lymphocyte ra
作者
任云霞
贺文婷
潘龙飞
李积安
REN Yunxia;HE Wenting;PAN Longfei(Department of Serous Cavity,Xi’an Chest Hospital,Xi’an 710100)
出处
《陕西医学杂志》
CAS
2020年第10期1207-1210,共4页
Shaanxi Medical Journal
