15例新型冠状病毒肺炎患者(COVID⁃19)的临床表现和CT影像学特征分析

Analysis of the clinical manifestations and computed tomography characteris⁃tics of patients with coronavirus disease⁃2019(COVID⁃19)

目的分析新型冠状病毒肺炎患者(COVID⁃19)的临床表现和CT影像学特征,进一步提高对该疾病的认识。方法对2020年1月以来本院确诊的15例新型冠状病毒肺炎患者的临床表现和CT影像学特征进行回顾性分析。结果本组病例以男性为主66.7%(10/15),年龄25~71岁之间,年龄中位数为54岁(四分位间距为37~65),大多为50岁以上患者(53.3%,8/15),15例均有疫区接触史(100%)。临床表现为发烧、咳嗽、干咳或有白色粘液痰,部分伴有胸闷、气促和乏力。患者胸部CT影像表现均处于病变早期和进展期,主要为双肺多个肺叶的斑片状磨玻璃样密度影,以胸膜下肺外周带分布为主,边缘模糊。可伴有血管增粗,胸膜增厚,支气管充气征和纵膈内淋巴结增多。15例患者针对新型冠状病毒ORF1ab和N基因的核酸检测均为阳性,且73.3%(11/15)患者的超敏C⁃反应蛋白升高。结论新型冠状病毒肺炎患者(COVID⁃19)发病早期以发热、咳嗽为主,均存在胸部CT检查异常。流行病学调查、临床表现、胸部CT影像学特征分析以及核酸检测等实验室检查结果相结合,有助于新型冠状病毒肺炎患者早期筛查与防控。

Objective To analyze the clinical presentations and computed tomography characteris⁃tics of coronavirus disease⁃2019(COVID⁃19)and to further improve the understanding of the disease.Meth⁃ods A retrospective analysis and summary of the clinical manifestations and CT imaging features were per⁃formed based on 15 patients with COVID⁃19 diagnosed in our hospital since January 2020.Results Most pa⁃tients diagnosed in this study were men,67%(10/15),aged 25 to 71 years,with a median age of 54 years(in⁃terquartile range of 37 to 65).Most of them were over 50 years old(53.3%,8/15).All 15 cases had a history of contact with the affected area(100%).The clinical manifestations are fever,cough,dry cough or sputum with white mucus,some accompanied by chest tightness,shortness of breath and fatigue.Most patients were in early or advanced disease stages,according to the chest imaging manifestations.They have a ground⁃glass patchy shadow in bilateral pulmonary multi⁃lobular lesions predominantly in the subpleural regions,blurred lesion mar⁃gins.They were also accompanied by thickening of blood vessels,thickening of the pleura,bronchial inflation and increased lymph nodes in the mediastinum in some cases.15 patients have positive nucleic acid tests for the novel coronavirus ORF1ab and N genes. In addition,93%(14/15)of patients have high level of hypersensitivity C-reactive protein. Conclusion COVID⁃19 patients have fever and cough at the early stage and there areabnormal chest CT examinations. The combination of epidemiological investigations,clinical manifestations,chest CT imaging characteristics analysis,and nucleic acid detection and other laboratory test results will helpearly screening,prevention and control of COVID-19.