不同类型新型冠状病毒肺炎临床特征分析

Analysis on the clinical characteristics of different types of COVID-19

目的:回顾性分析不同类型新型冠状病毒肺炎(COVID-19)患者的临床资料,探讨COVID-19的临床特征。方法:收集2020年2月10日至11日武汉火神山医院119例非危重症和30例危重症COVID-19患者人口学基本特征、基础疾病、临床表现以及重要检验指标,对2组患者数据进行统计学处理。结果:2组间性别差异无统计学意义,危重症患者以高龄者居多,临床表现大多是数个症状共同或先后出现。COVID-19常伴有基础疾病,其中最多为高血压,其次是冠心病及2型糖尿病。51.3%~63.3%患者同时患高血压病、冠心病及2型糖尿病等多种疾病。此外,危重型COVID-19患者的淋巴细胞计数、淋巴细胞百分比明显低于非危重型患者,而白细胞计数、白细胞百分比、C-反应蛋白(C-reactive protein,CRP)和降钙素原(procalcitonin,PCT)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)及α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase,α-HBDH)等指标,危重症患者则明显高于非危重症患者。LDH及α-HBDH存在明显的分层分布差别(P<0.001),且α-HBDH的曲线下的面积(AUC)高达0.936,高于CK-MB的0.775。结论:与非危重型COVID-19患者相比,危重型COVID-19患者年龄更大,临床表现和基础疾病更多、程度更重,炎性反应更明显。α-HBDH是判断COVID-19患者危重程度及心肌损伤的重要参考指标。

Objective:The clinical data of different types of patients with COVID-19 were retrospectively analyzed to explore the clinical features of COVID-19.Methods:119 cases of non-critical patients and 30 cases of critical patients with COVID-19 were recruited in Wuhan Huoshenshan Hospital from February 10-11,2020.And the basic demographic characteristics,basic diseases,clinical manifestations and important test indicators of them were collected.Then the data of non-critical patients and critical patients were processed by statistical analysis.Results:There was no gender difference between the two groups,most of the critically ill patients were the elderly,and the clinical manifestations were less with a single symptom,and most of the symptoms appeared together or successively.COVID-19 is often accompanied by underlying diseases,of which hypertension is the most common,followed by coronary heart disease and type 2 diabetes.51.3%-63.3%of patients often suffer from hypertension,coronary heart disease,type 2 diabetes and other diseases at the same time.In addition,the lymphocyte count and lymphocyte percentage in critical COVID-19 patients were significantly lower than those non-critical patients,while white blood cell count,leukocyte percentage,C-reactive protein(CRP)and procalcitonin(PCT),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)andα-hydroxybutyrate dehydrogenase(α-HBDH)in critical patients were significantly higher than those in non-critical patients.In addition,there was a significant difference in stratified distribution between LDH andα-HBDH(P<0.001),and the area under the curve ofα-HBDH was as high as 0.936,which was higher than that of 0.775 of CK-MB.Conclusions:Compared with non-critical COVID-19 patients,critical COVID-19 patients are older,with more clinical manifestations and underlying diseases,more severe,more obvious inflammatory response.α-HBDH is an important index to judge critical degree and myocardial injury in patients with COVID-19.