新型冠状病毒肺炎初诊临床特征及高分辨率CT影像表现

Clinical features and high resolution CT imaging findings of preliminary COVID-19

目的 探讨新型冠状病毒肺炎(COVID-19)患者初诊临床特征及胸部高分辨率CT(HRCT)影像表现。方法 回顾性搜集2020年1月20日至28日武汉大学人民医院经临床及核酸检测确诊的141例COVID-19患者,男77例,女64例,中位年龄49(9, 87)岁。分析141例COVID-19患者的临床特征、实验室检查指标以及胸部HRCT影像学表现。结果 141例COVID-19患者实验室检查发现白细胞计数降低38例(26.95%)、淋巴细胞比率降低71例(50.35%)。141例COVID-19患者中发热(>37.5 ℃) 139例(98.58%)、咳嗽106例(75.18%)、头痛11例(7.80%)、咳痰41例(29.08%)、胸闷93例(65.96%)、呼吸道以外症状主要有腹泻等4例(2.84%)。141例COVID-19患者HRCT均有异常,52例(36.88%)胸部HRCT图像表现为磨玻璃影(GGO)和斑片影,以胸膜下分布为主;23例(16.31%)GGO合并局灶实变影;27例(19.15%)小片状模糊影;20例(14.18%)大片状实变影;48例(34.04%)支气管血管束增粗和血管穿行征;5例(3.55%)有空气支气管征象;7例(4.96%)小结节影;5例(3.55%)纤维化、网格影或条索影;7例(4.96%)双侧胸腔积液,4例(2.84%)纵隔或双侧肺门淋巴结肿大。结论 COVID-19的临床特征及HRCT影像表现多样,在COVID-19特定的流行病学背景下,应及时开展胸部HRCT扫描,对疾病做出早期预警。

Objective To summarize the clinical and high resolution CT(HRCT)characteristics of 141 patients with COVID-19.Methods From January 20 to 28,2020,141 COVID-19 patients,77 males and 64 females,with a median age of 49(9,87),were enrolled in the study.The clinical features,laboratory test results and HRCT findings of all patients were analyzed retrospectively.Results In all of the patients,the decreasing leukocyte countin 38(26.95%)and lymphocyte ratio in 71(50.35%),a fever over 37.5℃in 139(98.58%),coughing in 106(75.18%),headache in 11(7.80%),expectoration in 41(29.08%),chest distress in 93(65.96%),and diarrhea in 4(2.84%)were found.The HRCT of all patients were abnormal,including ground glass opacity(GGO)with patchy opacity in 52(36.88%)mainly distributed along subpleural area,GGO with focal consolidation in 23(16.31%),small patchy opacity in 27(19.15%),large patchy consolidation in 20(14.18%),thickened bronchovascular bundleing and blood vessel crossing the lesion in 48(34.04%),air bronchus sign in 5(3.55%),small nodule in 7(4.96%),fibrous stripes and reticular opacities in 5(3.55%),bilateral pleural effusion in 7(4.96%),and mediastinal or bilateral hilar lymphadenopathy in 4(2.84%).Conclusions The clinical and HRCT manifestations of COVID-19 are various.Under the specific epidemiological background of COVID-19,chest HRCT scan should be carried out as soon as possible for early warning of this disease.