摘要
目的:探讨重型危重型新型冠状病毒感染者在门诊首诊时的临床特征和肺部CT表现。方法:回顾性分析发热门诊就诊的140例新型冠状病毒感染患者,其中中型组101例,重型危重型组39例。比较两组患者的一般人口学特征、临床表现、胸部薄层平扫CT(HRCT)检查及血常规+C反应蛋白(CRP)的差异性。结果:中型组和重型危重型组相比,(1)基线特征显示重型危重型组的年龄更高(66.05±14.38 vs.77.90±13.12),首诊时病程更短(5.40±3.81 vs.3.97±3.12),血氧饱和度(SPO2)更低(97.88±1.73 vs.92.92±4.01),体温峰值(Tmax)更高(38.32±0.66 vs.38.68±0.63);(2)肺部CT显示重型危重型组的肺炎容积半定量更大(18.85±13.51 vs.34.41±19.34);(3)血常规+CRP实验室检查显示重型危重型组的CRP更高(29.42±26.93 vs.80.67±48.01),淋巴细胞计数(LYM)更低(1.64±0.68 vs.0.95±0.64),粒细胞淋巴细胞比值更高(NLR)(3.48±2.46 vs.9.36±10.42)。(4)logistic回归分析显示年龄(OR=1.090,95%CI 1.006~1.181)、肺炎容积半定量(OR=1.086,95%CI1.086~1.019)和SPO2(OR=0.261,95%CI 0.089~0.762)与新冠病毒感染重症危重症的发生相关,差异具有统计学意义;CRP(OR=1.054,95%CI 1.023~1.087)和LYM(OR=0.039,95%CI 0.04~0.391)与新冠病毒感染重症危重症的发生相关,差异具有显著统计学意义。结论:高龄、首诊时病程更短、SPO2更低、肺炎容积半定量更大、CRP升高、LYM下降与后期发展至新冠感染重型危重型相关,需要早期识别。
Objective:Objective:To explore and analyze the clinical features and chest thin-slice non-enhanced computed tomography(CT)imaging features of patients with coronavirus disease 2019(COVID-19)at initial diagnosis in a fever clinic.Methods:A retrospective analysis was performed on 140 patients with COVID-19 at initial diagnosis in a fever clinic,including 101 and 39 cases in the moderate and severe and critical groups,respective-ly.Baseline,clinical characteristics,complete blood count+C-reactive protein(CBC+CRP),and chest thin-slice non-enhanced CT imaging characteristics of the patients were analyzed.Results:(1)The comparison between the moderate and severe and criti-cal groups showed that there were statistically significant differences in age(66.05±14.38 vs.77.90±13.12,),course of initial diagnosis(5.40±3.81 vs.3.97±3.12),SPO2(97.88±1.73 vs.92.92±4.01),and Tmax(38.32±0.66 vs.38.68±0.63).(2)CT features between the two groups showed statistically significant differences in semi-quantitative volume(18.85±13.51 vs.34.41±19.34).(3)The comparison between the moderate and severe and critical groups showed that there were statistically significant differ-ences in CRP(29.42±26.93 vs.80.67±48.01),LYM(1.64±0.68 vs.0.95±0.64),and NLR(3.48±2.46 vs.9.36±10.42).(4)Six indicators,namely age,the course of initial diagnosis,SPO2,semi-quantitative volume,CRP,and LYM,were screened for multivariate logistic regression analysis.The result show that age(OR=1.090,95%CI 1.006~1.181),semi-quantitative(OR=1.086,95%CI 1.086~1.019),and SPO2(OR=0.261,95%CI 0.089~0.762),are related to the occurrence of severe and critical COVID-19 infection,and the difference is statistically significant;CRP(OR=1.054,95%CI 1.023~1.087)and LYM(OR=0.039,95%CI 0.04~0.391)are related to the occurrence of severe and critical COVID-19 infection,and the difference is significant statistically significant.Conclusion:Age,lower SPO2 and LYM,a shorter course;a higher Tmax,semi-quantitative volume,CRP,and NLR are associ-ated with severe and critical cases
作者
刘晓燕
鲍中英
段淑红
张捷
张明霞
孙莹
李玲
王仁贵
LIU Xiaoyan;BAO Zhongyinga;DUAN Shuhong;ZHANG Jie;ZHANG Mingxia;SUN Ying;LI Ling;WANG Rengui(Department of Infectious Diseases,Beijing Shijitan Hospital of Capital Medical University,Beijing 100038;Department of Radiology,Beijing Shijitan Hospital of Capital Medical University,Beijing 100038)
出处
《CT理论与应用研究（中英文）》
2023年第5期636-644,共9页
Computerized Tomography Theory and Applications
基金
北京市科技计划项目(基于AI技术的肺炎影像学精准诊断系统构建及应用(Z211100003521009))。
