摘要
目的探讨新型冠状病毒肺炎(COVID-19)患者的临床特征及重型患者的危险因素。方法回顾性分析2020年2—4月武汉火神山医院收治的216例COVID-19患者的临床资料,根据病情分为普通型组174例和重型组42例。比较2组性别、年龄、基础疾病、血常规、C反应蛋白(CRP)、降钙素原(PCT)、凝血功能、心肌酶谱、脑钠肽(BNP)、肝肾功能,分析2组临床特征及转为重型的危险因素。结果与普通型组比较,重型组气短、乏力症状更多,年龄、白细胞(WBC)、中性粒细胞(NEU)、CRP、BNP、凝血酶原时间(PT)、D-二聚体(D-D)、总胆红素(TBIL)、直接胆红素(DBIL)、乳酸脱氢酶(LDH)及肌钙蛋白I(cTnI)水平增高,淋巴细胞(LYM)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)及血清白蛋白(ALB)水平降低(P<0.05,P<0.01)。多因素Logistic回归分析显示,LYM降低及D-D水平增高是普通型COVID-19患者转为重型的独立危险因素(P<0.05)。结论COVID-19患者在炎症指标、凝血功能、心肌及肝功能等方面有不同程度的损伤,重型组更严重,LYM降低及D-D增高对普通型COVID-19患者转为重型有良好的预测价值。
Objective To investigate clinical characteristics of patients with corona virus disease 2019(COVID-19)and risk factors of severe COVID-19 patients.Methods Clinical data of 216 COVID-19 patients admitted in the HUOSHENSHAN Hospital of Wuhan from February to April 2020 was retrospectively analyzed,and the patients were divided into general group(n=174)and severe group(n=42)according to seriousness of pathogenetic conditions.In two group,conditions of gender,age,underlying diseases,blood routine,C-reactive protein(CRP),procalcitonin(PCT),coagulation function,myocardial enzyme spectrum,brain natriuretic peptide(BNP)and functions of liver and kidney were compared,and clinical characteristics and risk factors were analyzed in two groups.Results Compared with those in general group,numbers of patients having short breath and acratia,and levels of age,white blood cell(WBC),neutrophilic granulocyte(NEU),CRP,BNP,prothrombin time(PT),D-dimer(D-D),total bilirubin(TBIL),Direct bilirubin(DBIL),lactate dehydrogenase(LDH)and Troponin I(cTnI)were significantly increased,while levels of lymphocyte(LYM),erythrocyte(RBC),hemoglobin(HB),platelet(PLT)and serum albumin(ALB)were significantly decreased in severe group(P<0.05,P<0.01).Multifactor logistic regression analysis showed that decreasing LYM and increasing D-D were independent risk factors of general COVID-19 patients changing to severe patients(P<0.05).Conclusion Different degrees of injuries may be found in inflammatory indexes,coagulation function,myocardial injury and liver function of COVID-19 patients,and the degrees are worse in severe patients.Decreasing LYM and increasing D-D have good predictive value for general COVID-19 patients changing to severe patients.
作者
谢晓燕
郭玮
雷燕
李双双
王晓坤
王娟
郭永博
张兵华
XIE Xiao-yan;GUO Wei;LEI Yan;LI Shuang-shuang;WANG Xiao-kun;WANG Juan;GUO Yong-bo;ZHANG Bing-hua(Department of Respiratory Diseases,the Third Department of Cadre Wards,1.the 986th Hospital of PLA Air Force,Xi'an 710054,China;Department of Infection Prevention and Control,the Third Department of Cadre Wards,1.the 986th Hospital of PLA Air Force,Xi'an 710054,China;the Third Department of Cadre Wards,1.the 986th Hospital of PLA Air Force,Xi'an 710054,China;the Third Department of Infection Diseases,Huoshenshan Hospital of Wuhan,Wuhan 430000,China)
出处
《解放军医药杂志》
CAS
2020年第10期1-5,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
