摘要
目的分析2019新型冠状病毒肺炎(COVID-19)治愈出院患者的临床特征。方法选取2020年2月3日至2月22日于华中科技大学同济医学院附属同济医院治愈出院的76例COVID-19患者为研究对象,其中轻症组42例,重症组34例。对比分析2组患者的临床症状、实验室检查、影像学资料间的差异及其与病情严重程度的关系。结果76例患者的平均年龄为(53.3±15.1)岁。男性39例,女性37例,其中男性较女性发生重症肺炎的比例更高[61.5%(24/39)vs.27.0%(10/37),P=0.003]。重症组中合并高血压的比例更高(P<0.05)。重症组患者的发热比例(100.0%)高于轻症组(73.8%)(P<0.01)。重症组CT提示双肺弥漫感染的比例(95.2%)高于轻症组(73.5%)(P<0.05)。重症患者的白细胞计数平均值[(6.19±3.22)×10^9/L]较轻症患者[(4.90±1.57)×10^9/L]高(P<0.05)。重症患者的超敏C反应蛋白(hsCRP)、铁蛋白、D-D二聚体、乳酸脱氢酶(LDH)、IL-2R、IL-6、IL-10、TNF-α水平明显高于轻症患者(均P<0.01)。ROC曲线分析提示,IL-2R预测患者疾病严重程度的价值最高,其曲线下面积(AUC)为0.908,灵敏度为91.7%,特异度为82.4%。结论男性、合并基础疾病、发热、CT提示双肺感染是COVID-19发展为重症的高危因素,而hsCRP、铁蛋白、D-D二聚体、LDH、IL-2R等指标有助于预测COVID-19病情的进展,其中IL-2R预测效果最佳。
Objective To analyze clinical features of cured patients with 2019 novel coronavirus pneumonia(COVID-19),and summarize experience,in order to guide epidemic prevention work.Methods In total,76 cured patients discharged from the fever ward of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from February 3 rd to February 22 nd,2020 were selected as the study objects,including 42 patients in the mild group and 34 patients in the severe group.The differences of clinical symptoms,laboratory examination and imaging data between the two groups and their relationship with the severity of clinical conditions were analyzed.Results The average age of the patients was(53.3±15.1)years,including 39 males and 37 females.The incidence of severe pneumonia in men was higher than that in women[24 cases(61.5%)and 10 cases(27.0%),P=0.003].The proportion of severe group with hypertension and other basic diseases was higher than that of mild group(P<0.05).And the fever rate in severe group(100.0%)was higher than that in mild group(73.8%)(P<0.01).The CT imaging showed that the proportion of diffuse infection in severe group(95.2%)was higher than that in mild group(73.5%)(P<0.05).The mean value of leukocyte count in severe patients[(6.19±3.22)×10^9/L]was higher than that in mild patients[(4.90±1.57)×10^9/L].The levels of hsCRP,ferritin,D-D dimer,LDH,IL-2 R,IL-6,IL-10 and TNF-αin severe patients were significantly higher than those in mild patients(all P<0.01).According to ROC curve analysis,AUC of IL-2 R was the largest,and its value of predicting disease severity was the highest.And the AUC was 0.908,the sensitivity was 91.7%,and the specificity was 82.4%.Conclusion Men,combined with basic diseases,fever and CT imaging indicating both-side pulmonary infection are high risk factors for COVID-19 developing into severe disease.Serum hsCRP,ferritin,D-D dimer,LDH and cytokines IL-2 R are helpful to predict the progression and prognosis of COVID-19.
作者
杨坚坚
王雪
陶玉
田义涛
张霓
付向宁
王永勇
Yang Jianjian;Wang Xue;Tao Yu(Department of Thoracic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Respiratory Medicine and Critical Care Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2020年第5期609-613,共5页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
