普通型新型冠状病毒肺炎临床及影像特征分析

Common Novel Coronavirus Pneumonia(COVID-19):Clinical and Imaging Features

目的:回顾性分析普通型COVID-19患者的临床及影像资料,分析其特征,探讨二者的变化过程。方法:根据住院期间肺部病灶是否有进展将21例COVID-19患者分为平稳组与进展组,分析并比较两组临床及影像资料。结果:①首诊症状以发热(52.38%)、咳嗽(38.09%)为主,4例(19.04%)无明显症状;②平稳组患者的肺部病灶在总病程第(13.06±5.41)天开始吸收,进展组在第(12.80±7.19)天开始进展,第(17.20±7.40)天开始吸收;两组在住院前病程、住院时间及总病程上均无统计学差异。③普通组和进展组不同时期的白细胞计数、中性粒细胞计数、淋巴细胞计数及NLR组内比较无统计学差异;入院时NLR组间比较具有统计学差异,进展组高于平稳组。④肺部病灶累及一个肺叶5例(26.32%),两个肺叶2例(10.53%),三个肺叶3例(15.79%),四个肺叶5例(26.32%),五个肺叶4例(21.05%);影像表现:单纯磨玻璃影8例(42.11%),磨玻璃影伴实性成分11例(57.89%);5例(26.31%)见“铺路石征”,16例(84.21%)见“蒲公英果实征”,10例(52.63%)见“蒲公英种子征”;胸膜增厚10例(52.63%)。结论:综合分析临床表现、实验室及CT检查结果可以提高普通型COVID-19的诊断能力,入院时NLR对疾病的进展有一定预测价值。

Objective:To analyze the clinical and imaging data of common COVID-2019 patients,analyze their characteristics,and explore the change process.Methods:According to the progress of pulmonary lesions during hospitalization,21 patients with COVID-2019 were divided into stable group and progressive group,analysed and compared the clinical and imaging data of two groups.Results:①Fever(52.38%)and cough(38.09%)were the main symptoms in the first diagnosis,and 4 cases(19.04%)had no obvious symptoms;②The pulmonary lesions in the stable group began to absorb on the(13.06±5.41)day of the total course of disease,the progressive group began to absorb on the(12.80±7.19)day,and the progressive group began to absorb on the(17.20±7.40)day;There was no statistical difference in the course of disease,length of hospitalization and the total course of disease between the two groups before hospitalization.③There were no statistical differences in WBC count,neutrophil count,lymphocyte count and NLR group in different periods between the general group and the progress group;There were statistical differences between the NLR group at admission,and the progress group was higher than the stable group.④Pulmonary lesions involved one lobe in 5 cases(26.32%),two lobes in 2 cases(10.53%),three lobes in 3 cases(15.79%),four lobes in 5 cases(26.32%),five lobes in 4 cases(21.05%);imaging manifestations:simple ground glass shadow in 8 cases(42.11%),ground glass shadow with solid components in 11 cases(57.89%);paver sign in 5 cases(26.31%),dandelion fruit sign in 16 cases(84.21%),Seed sign of dandelion in 10 cases(52.63%)and 10 cases(52.63%)had pleural thickening.Conclusion:Comprehensive analysis of clinical manifestations,laboratory and CT manifestations can improve the diagnostic ability of common COVID-2019.NLR has a certain predictive value for the progress of the disease when admitted.