摘要
目的:探讨新型冠状病毒肺炎(COVID-19)患者临床特征和死亡影响因素。方法:收集武汉火神山医院2020年2~4月收治的316例患者,分为死亡组(53例)与非死亡组(263例),对比分析两组入院时的临床特征、胸部影像学表现及实验室检查情况。采用Logistic回归分析影响COVID-19患者死亡的相关因素。结果:与非死亡组患者相比,死亡组重型、危重型比例及男性比例较多,年龄更大,合并高血压、慢性肾病比例大,咳痰症状比例低,磨玻璃影、纤维条索影表现比例较低,肺实变影表现比例高,差异均有统计学意义(均P<0.05)。Logistic回归分析显示降钙素原、C反应蛋白、乳酸脱氢酶、D二聚体与磨玻璃影表现为COVID-19患者死亡的影响因素(均P<0.05)。结论:应积极关注合并高血压、慢性肾病与咳痰症状减少的中老年男性重症患者,降钙素原、C反应蛋白、乳酸脱氢酶与D二聚体水平升高是COVID-19患者死亡的危险因素,磨玻璃影等胸部影像学表现可作为疾病严重程度的动态观察指标。
Objective: To investigate the clinical characteristics and factors influencing death in patients with novel coronavirus pneumonia(COVID-19). Methods: 316 patients admitted to Wuhan Vulcangshan Hospital from February 2020 to April 2020 were collected, and divided into death group(53 cases) and non-death group(263 cases). The clinical characteristics, chest imaging manifestations and laboratory tests at admission were compared. The factors influencing the death of COVID-19 patients were analyzed by logistic regression. Results:Compared with the non-death group, the proportion of heavy and critical types, males, combined hypertension and chronic kidney disease, and solid lung shadow manifestations was higher in death group, while the proportion of cough symptoms, ground glass shadow and fibrous streak shadow manifestations was lower(P<0.05). Logistic regression analysis showed that procalcitonin, C-reactive protein, lactate dehydrogenase, D-dimer, and ground-glass shadow were factors influencing death in patients with COVID-19(P<0.05). Conclusion: Attention should be paid to the middle-aged and elderly male critically ill patients complicated with hypertension,chronic kidney disease and reduced cough symptoms;elevated levels of procalcitonin, C-reactive protein, lactate dehydrogenase and D-dimer are risk factors for death in COVID-19 patients;Chest imaging findings such as ground glass shadow can be used as dynamic indicators of disease severity.
作者
肖飞
马利贤
陆恩峰
黄丽萍
尹国栋
潘江红
关敏霞
Xiao Fei;Ma Lixian;Lu Enfeng;Huang Liping;Yin Guodong;Pan Jianghong;Guan Mingxia(Department of Respiratory Medicine,The 923rd Hospital of PLA Joint Logistics Support Force,Nanning530028,China;Department of Cardiac and Renal Medicine,The 923rd Hospital of PLA Joint Logistics Support Force,Nanning530028,China;Department of Orthopedic Surgery,The 923rd Hospital of PLA Joint Logistics Support Force,Nanning530028,China)
出处
《广西医科大学学报》
CAS
2021年第9期1755-1759,共5页
Journal of Guangxi Medical University
基金
广西自然科学基金(No.2017GXNSFAA198364)。
