摘要
目的:探讨新型冠状病毒肺炎(COVID-19)患者的临床特征、CT影像学表现及其在不同年龄组之间的表现差异。方法:连续搜集两个医疗机构2020年1月至3月收治的37例新型冠状病毒肺炎(COVID-19)患者的临床及CT影像资料。其中,男21例,女16例,年龄21~84岁,平均年龄为44.32岁。对所有患者的临床特征、实验室检查及CT影像学表现进行回顾性分析。结果:大多数(31/37,84%)患者具有2周内武汉疫情直接或间接接触史;临床以发热(23/37,62%)、咳嗽(17/37,47%)及乏力(7/37,19%)为主诉。实验室检查白细胞计数多正常(28/37,76%)或降低(9/37,24%),中性粒细胞(29/37,78%)及淋巴细胞(31/37,84%)计数多正常,少数降低或升高,血清C反应蛋白正常(20/37,54%)或升高(17/37,46%);CT影像表现:37例患者除4例(4/37,11%)肺部CT表现阴性外,32例具有磨玻璃影(GGO)(32/33,97%);其他伴随影像学表现包括:病灶内血管增粗(17/33,52%),小叶间隔增厚(16/33,48%),局部实变(9/33,27%),结节影(5/33,15%)及蜂窝样改变(2/33,6%),病灶外周或混合分布。所有患者均未见胸水及纵隔淋巴结病变。在年龄方面,中性粒细胞及淋巴细胞计数与年龄具有明显相关性(P<0.05),老年组病灶内更易见血管增粗影(8/9,89%)。结论:新型冠状病毒肺炎(COVID-19)肺部影像学表现多样,但具有一定的特征性,需结合实验室及临床表现综合判断,高分辨率CT(HRCT)检查是临床作出早期诊断及防控干预的重要依据。
Purpose:To explore the clinical features,CT imaging findings and differences among different age groups of patients with COVID-19.Methods:The clinical and CT data of 37 patients with SARS-CoV-2 infection in two institutions from January to March,2020 were collected.Among them,There were 21 males and 16 females,aged 21~84 years,with an average age of 44.32 years.The clinical features,laboratory examination and CT imaging findings of all patients were analyzed retrospectively.Results:The majority of patients had a history of direct or indirect contact with the epidemic situation in Wuhan within 2 weeks.The most common clinical symptoms were fever(23/37,62%),cough(17/37,47%)and fatigue(7/37,19%).Laboratory examinations showed that most of the white blood cell counts were normal(28/37,76%)or decreased(9/37,24%),neutrophils(29/37,78%)and lymphocytes(31/37,84%)were mostly normal,and a few of them were decreased or increased.The serum C-reactive protein was normal(20/37,54%)or increased(17/37,46%).In terms of CT imaging findings,except for 4(4/37,11%)patients with negative pulmonary CT,32 patients had ground glass opcities(GGO)(32/33,97%),and other imaging findings included thickening of blood vessels in the lesion(17/33,52%),thickening of interlobular septum(16/33,48%),local consolidation(9/33,27%),nodules(5/33,15%)and honeycomb-like changes(2/33,6%).Lesions were often peripherally distributed or mixed distributed.No pleural effusion and mediastinal lymphadenopathy were found in all patients.Correlation analysis showed that age was significantly correlated with the values of neutrophil and lymphocyte count(P<0.05),and the CT images showed that lesion with dilatation of vessels was more likely to be seen in the elderly group.Conclusion:The CT findings of COVID-19 are various,but they have certain characteristics,which need to be judged comprehensively in combination with laboratory and clinical manifestations.High-resolution CT(HRCT)examination is an important basis for early diagnosis and prevention and control interve
作者
胡小丽
邓雪
杨季春
李磊
张堃
李平
沈宏荣
Hu Xiaoli;Deng Xue;Yang Jichun;Li Lei;Zhang Kun;LI Ping;Shen Hongrong(Department of Radiology,The First Affliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007;Department of Radiology,The Central Hospital of Yongzhou City,Yongzhou,Hunan 425000)
出处
《现代医用影像学》
2020年第12期2171-2175,共5页
Modern Medical Imageology
基金
国家自然科学基金青年科学基金(81603482)
湖南省自然科学基金(2016JJ6115)
中国博士后科学基金面上项目(2017M622586)
湖南中医药大学重点学科建设项目(4901-020000200806)。
