摘要
目的 分析新型冠状病毒奥密克戎变异株所致肺炎的临床特征及预后因素。方法 回顾性分析2022年12月至2023年1月新型冠状病毒肺炎患者349例。根据病情严重程度将患者分为非重症组(285例)和重症组(64例)。比较两组患者一般情况、基础疾病、临床症状、实验室检查、影像学表现、治疗情况和预后转归。结果 重症组患者年龄、基础疾病比例高于非重症组,但重症组疫苗接种率低于非重症组(P<0.05)。重症组淋巴细胞计数、白蛋白水平明显低于非重症组,而重症组CRP水平高于非重症(P<0.05)。影像学方面,重症组入院首次胸部CT影像病灶主要表现为实变影、磨玻璃合并实变影;非重症组入院首次胸部CT影像病灶主要表现为磨玻璃影、磨玻璃合并实变影,两组均表现为以双侧、多肺叶受累及以两肺外带为主的病灶分布特点。重症组患者,其中好转23例,死亡38例,转院3例,非重症组患者好转284例,转院1例,无死亡病例,两组预后方面比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示年龄越大(OR:1.076,95%CI:1.038~1.115)、CRP越高(OR:1.022,95%CI:1.005~1.039)、白蛋白越低(OR:0.723,95%CI:0.530~0.986),重症患者死亡风险越高(P<0.05)。结论 年龄、CRP水平、白蛋白水平是影响重症新型冠状病毒肺炎患者预后的高危因素,临床需早期积极干预治疗,以降低病死率,提高患者预后。
Objective To summarize and analyze the clinical characteristic and prognostic factors of COVID-19 caused by Omicron variants.Methods 349 cases of novel coronavirus pneumonia from December 2022 to January 2023 were analyzed retrospectively.According to the severity of the disease,the patients were divided into the non-critical group and the critical group.The data of general condition,underlying disease,clinical symptoms,laboratory examination,imaging findings,treatment and prognosis of patients were collected and statistically analyzed.Results The average age and the proportion of underlying diseases in the severe group were higher than those in the non-severe group,but the vaccination rate in the severe group was lower than that in the non-severe group(P<0.05).The lymphocyte count and albumin level in the critical group were significantly lower than those in the non-critical group,while the C-reactive protein(CRP)level in the critical group was significantly higher than that in the non-critical group(P<0.05).In terms of imaging,the lesions on chest CT images first admitted to the critical group were mainly manifested as solid shadow,ground glass shadow combined with solid shadow,while the lesions on chest CT images first admitted to the non-critical group were mainly manifested as ground glass shadow,ground glass shadow combined with solid shadow.Both groups showed the distribution characteristics of lesions with bilateral and multiple lung lobes involved and mainly in the outer bands of both lungs.There were 64 patients in the critical group,of which 23 were improved,38 died,and 3 were transferred to hospital.There were 285 patients in the non-critical group,among which 284 were improved,1 was transferred to hospital,and 0 died.There was statistical significance in prognosis between the two groups(P<0.05).Multivariate Logistic regression analysis showed that the older the age(OR:1.076,95%CI:1.038~1.115),the higher the CRP(OR:1.022,95%CI:1.005~1.039)and the lower the albumin(OR:0.723,95%CI:0.530~0.986),the highe
出处
《浙江临床医学》
2024年第3期359-361,共3页
Zhejiang Clinical Medical Journal
