鄂州市342例新型冠状病毒肺炎患者实验室检测指标与临床分型相关性分析

Correlation of laboratory index and clinical classification among 342 corona virus disease 2019 patients in Ezhou

目的分析鄂州市新型冠状病毒肺炎(COVID-19)患者实验室检测指标与临床分型的相关性。方法选取2020年1月23日-2月12日鄂州市中心医院COVID-19住院患者342例,其中普通患者196例(普通组)、重症患者97例(重症组)、危重症患者49例(危重症组)。对各组年龄、性别、基础疾病、合并感染情况、血液学指标进行比较。采用受试者工作特征(ROC)曲线评价各项指标对COVID-19的辅助诊断价值。结果 3组之间年龄、基础疾病患病率差异均有统计学意义(P<0.05),危重症组男性比例高于女性(P<0.05);3组之间其他呼吸道病原体合并感染率差异有统计学意义(P<0.05),感染率最高的均为肺炎支原体感染和乙型流感病毒感染。与普通组比较,重症组淋巴细胞百分比(LYMPH%)、总蛋白(TP)、白蛋白(Alb)显著降低(P<0.05),D-二聚体(DD)、纤维蛋白原(Fg)、红细胞沉降率(ESR)、C反应蛋白(CRP)显著升高(P<0.05);与重症组比较,危重症组LYMPH%、TP、Alb显著降低(P<0.05),白细胞(WBC)、DD、降钙素原(PCT)显著升高(P<0.05)。ROC曲线分析结果显示,区分普通患者与重症患者最有价值的指标是ESR、Alb和LYMPH%;区分重症患者与危重症患者最有价值的指标是PCT、LYMPH%、Alb。结论检测COVID-19患者ESR、Alb、LYMPH%和PCT等指标有助于判断病情。

Objctive To investigate the correlation of laboratory index and clinical classification in corona virus disease 2019(COVID-19)patients.Methods A total of 342 patients with COVID-19 in Ezhou Central Hospital from January 23,2020 to February 12,2020 were enrolled.There were 196 cases of general group,97 cases of severe group and 49 cases of critical group.Their age,sex,basic diseases,co-infection and blood indexes were compared.Receiver operating characteristic(ROC)curve was used to evaluate the roles of blood indexes in the diagnosis of COVID-19.Results The age and prevalence of basic diseases among the 3 groups had statistical significance(P<0.05).The proportion of males in critical group was higher than that of females(P<0.05).The infection rate of co-infection with other respiratory pathogens had statistical significance among the 3 groups(P<0.05).The infection rates of Mycoplasma pneumoniae and influenza B virus were the highest.In severe group,lymphocyte percentage(LYMPH%),total protein(TP)and albumin(Alb)were lower than those in general group(P<0.05),while D-dimer(DD),fibrinogen(Fg),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were higher(P<0.05).In critical group,LYMPH%,TP and Alb were lower than those in severe group(P<0.05),while white blood cell(WBC)count,DD and procalcitonin(PCT)were higher(P<0.05).According to ROC curve analysis,ESR,Alb and LYMPH%were the most valuable blood indexes to distinguish general and severe groups,and PCT,LYMPH%and Alb were the most valuable blood indexes to distinguish severe and critical groups.Conclusions ESR,Alb,LYMPH%and PCT determinations are helpful to diagnose the conditions.