2型糖尿病合并新型冠状病毒肺炎患者临床及CT影像特点分析

Clinical and CT images characteristics of type 2 diabetes mellitus combined with new coronavirus pneumonia

目的 分析T2DM合并新型冠状病毒肺炎(COVID-19)患者的临床及电子计算机断层扫描(CT)特点.方法 选取2019年12月至2020年2月于我院收治的26例T2DM合并COVID-19患者.收集一般临床资料、血糖水平、胸部CT影像等.分析其CT表现及血糖控制与疾病转归的关系.结果 26例患者以进展期及重症期为主,CT表现多样,双肺分布23例,累及3个肺叶以上20例,呈"铺路石"征13例,实变并支气管充气征15例,白肺5例.血糖控制良好患者11例,控制不佳患者15例,血糖控制良好的疗效与控制不佳比较,差异有统计学意义(P<0.05).结论 T2DM合并COVID-19患者重症比例较高,CT表现为多叶受累,病灶范围分布广泛,"铺路石"征及实变伴支气管充气征常见,少数呈"白肺"表现,积极控制血糖有利于疾病转归.

Objective To analyze the clinical and CT characteristics of type 2 diabetes mellitus(T2DM)patients with novel coronavirus pneumonia(COVID-19).Methods Twenty-six patients with T2DM and COVID-19 diagnosed in our hospital were selected in this study from December,2019 to February,2020.Their general clinical informations,blood glucose levels and chest CT images were collected.The CT characteristics and the relationship between blood glucose control and disease outcome were analyzed.Results Most of the 26 patients were in advanced and severe stages of COVID-19 with diverse CT manifestations.CT results from 23 patients showed lesions involving both lungs,including 20 patients involving more than three lobes.There were 13 patients with crazy-paving pattern,15 patients with consolidation and air bronchogram and 5 patients with"white lung".There were 11 patients with satisfactory blood glucose control,while 15 patients with poor control.The COVID-19 outcome was significantly different between patients with good blood glucose control and those with poor control(P<0.05).Conclusion Patients with T2DM and COVID-19 have a higher proportion of severe cases.CT showed multiple lobes involvement and extensive distribution of lesions.Crazy-paving pattern and consolidation with air bronchogram are common,and a few patients showed"white lungs".Satisfactory control of blood glucose is beneficial to the outcome of COVID-19.