新型冠状病毒肺炎与甲型H1N1流感肺炎的临床特征及HRCT胸部影像学比较

Clinical Features of Novel Coronavirus Pneumonia and H1N1 Influenza Pneumonia and Comparison of HRCT Chest Imaging

目的比较新型冠状病毒肺炎(Novel coronavirus pneumonia,NCP)与甲型H1N1流感肺炎的早期临床特征及胸部HRCT影像学特点。方法回顾性分析40例NCP患者与41例甲型H1N1流感肺炎患者的早期临床表现、实验室检查和胸部HRCT影像学资料,其中NCP组根据临床分为普通组和重型组。结果 40例NCP与41例甲型H1N1流感肺炎患者的早期临床表现、实验室检查差异无统计学意义(P=0.292);早期胸部影像学征象上NCP组和H1N1组基本影像改变主要是双肺下叶中外带磨玻璃影;NCP组患者病灶呈小结节状、片团状亚实变、实变及纤维化多于H1N1组患者(P<0.05),且病灶容易累及中叶。NCP组的重型组较普通型组在早期更容易出现小结节、实变、纤维化并伴随胸膜增厚及胸腔积液。结论与H1N1组患者相比,NCP组患者早期肺部病变累及范围广,容易形成亚实变、实变、纤维化,进展迅速。HRCT检查能客观反映二者的影像学特征,在一定程度上有助于鉴别诊断,有助于指导临床早期诊断及治疗。

Objective To compare the early clinical features and chest HRCT imaging features of novel coronavirus pneumonia( NCP) and H1N1 influenza pneumonia.Methods The clinical manifestations,laboratory examinations and chest HRCT imaging data of 40 patients with NCP and 41 patients with H1N1 influenza pneumonia were retrospectively analyzed.The NCP group was divided into normal and severe groups according to clinical conditions.Results There was no significant difference in early clinical manifestations and laboratory examinations between 40 NCP and 41 H1N1 influenza pneumonia patients( P = 0.292);in the early chest imaging signs,the basic image changes in the NCP group and the H1N1 group were mainly ground glass in the lower and middle lobe of both lungs;the patients in the NCP group had more nodules,patch-like sub-consolidations,consolidation and fibrosis than those in the H1N1 group( P<0.05),and the lesions easily involved the middle lobe.In the NCP group,the heavy-duty group is more prone to small nodules,consolidation,fibrosis,and pleural thickening and pleural effusions in the early stage than the normal group.Conclusion Compared with patients in H1N1 group,patients with NCP group have a wide range of early lung lesions,which are easy to form sub-consolidation,consolidation,fibrosis,and progress rapidly.HRCT examination could objectively reflect the imaging characteristics of the two,to a certain extent,it is helpful for differential diagnosis and guidance of early clinical diagnosis and treatment.