多种血液学指标在新型冠状病毒肺炎中的诊断价值

Diagnostic roles of several parameters in corona virus disease 2019

目的观察分析新型冠状病毒肺炎(COVID-19)普通型患者和重症患者之间以及重症患者治疗过程中血常规指标、生化指标及D-二聚体(DD)检测结果的特点,为临床诊疗提供依据。方法回顾性分析296例COVID-19患者的各项检测指标,对其中30例重症患者治疗过程中的血常规指标、生化指标和DD进行动态观察。以100例普通肺炎患者作为对照组。结果COVID-19重症组淋巴细胞百分比(LYMPH%)、淋巴细胞绝对数(LYMPH#)、血小板(PLT)计数均低于COVID-19普通型组(P<0.05),中性粒细胞绝对数(NEUT#)、中性粒细胞/淋巴细胞比值(NLR)、天门冬氨酸氨基转移酶(AST)、尿素、肌酸激酶(CK)、乳酸脱氢酶(LDH)、DD均高于COVID-19普通型组(P<0.05)。与对照组比较,COVID-19重症组白细胞(WBC)计数、PLT计数、NEUT#、LYMPH#、LYMPH%均降低,NLR、LDH均升高(P<0.05);COVID-19普通型组WBC计数、PLT计数、NEUT#、NLR、LYMPH#、尿素、CK、DD、LDH均降低(P<0.05),LYMPH%升高(P<0.05)。30例重症患者中有7例病情加重或转危重,其WBC计数、NEUT#、NLR持续升高,LYMPH#持续降低。23例病情好转或病毒核酸转阴患者入院前期各项指标均异常,随后逐渐恢复正常。结论血常规指标、生化指标及DD检测结果对COVID-19的诊疗具有重要的参考价值。

Objective To observe the characteristics of blood routine items,biochemical indexes and D-dimer(DD)of general and severe corona virus disease 2019(COVID-19)patients and in the treatment of severe COVID-19,and to provide a reference for COVID-19 clinical diagnosis and treatment.Methods Totally,296 COVID-19 patients were analyzed retrospectively.A total of 100 patients with common pneumonia were enrolled as control group.The changes of blood routine items,biochemical indexes and DD in 30 severe COVID-19 patients were analyzed dynamically.Results In severe COVID-19 group,lymphocyte percentage(LYMPH%),the absolute value of lymphocyte(LYMPH#)and platelet(PLT)count were lower than those in general COVID-19 group(P<0.05).The absolute value of neutrophil(NEUT#),neutrophil/lymphocyte ratio(NLR),aspartate aminotransferase(AST),urea,creatine kinase(CK),lactate dehydrogenase(LDH)and DD were higher than those in general COVID-19 group(P<0.05).In severe COVID-19 group,white blood cell(WBC)count,PLT count,NEUT#,LYMPH#,LYMPH%were lower than those in control group,and NLR and LDH were higher(P<0.05).Compared with control group,in general COVID-19 group,WBC count,PLT count,NEUT#,NLR,LYMPH#,urea,CK,DD and LDH were lower,and LYMPH%were higher(P<0.05).There were 7 of 30 severe cases aggravated or turned to critical state,and their WBC count,NEUT#and NLR were higher than normal levels,while LYMPH#was lower than normal level.The above indexes in 23 patients who were improved or virus nucleic acid turned negative were gradually recovered to normal levels.Conclusions Blood routine items, biochemical indexes and DD are important for the diagnosis and treatment of COVID-19.