永州市44例新型冠状病毒感染的肺炎患者临床特征分析

Clinical characteristics of 44 patients with coronavirus disease 2019 in Yongzhou

目的:分析永州市新型冠状病毒感染的肺炎患者的一般情况及临床特征,为新型冠状病毒感染的肺炎防治提供参考。方法:将在永州市中心医院收治的44例新冠肺炎确诊患者纳入为研究对象。按临床分型情况分两组,轻型及普通型组32例,重型及危重型组12例。比较两组一般情况、流行病学、临床症状、既往史及出现的并发症,实验室检查、影像学特征及治疗方案等情况,总结临床特点及治疗经过和预后。结果:重型及危重型组跟轻型及普通型组两组年龄、性别、能明确的潜伏期、能明确的发病代数,差异均无统计学意义(P>0.05)。两组住院天数比较,差异有统计学意义(P<0.05)。两组入院时发热、咳嗽、乏力、咽痛、鼻塞、流涕、腹泻等临床症状,差异均无统计学意义(P>0.05)。两组既往病史中患有高血压病、2型糖尿病,差异均无统计学意义(P>0.05);两组在住院期间发生低钾血症、谷草转氨酶升高比例,差异有统计学意义(P<0.05);发生低蛋白血症、谷丙转氨酶升高、呼吸功能衰竭、心功能衰竭,差异均无统计学意义(P>0.05)。两组实验室检查结果及CT结果中白细胞计数升高、中性粒细胞计数增多、淋巴细胞计数减少及CT病变为多叶病灶,差异均有统计学意义(P<0.05);白细胞计数减少、中性粒细胞计数减少、嗜酸性粒细胞计数减少、C反应蛋白升高、血沉升高、乳酸脱氢酶升高、CT病变为磨玻璃样及以胸膜下或肺外带为主的情况,差异均无统计学差异(P>0.05)。治疗方案中抗生素、激素、免疫球蛋白、无创呼吸机的使用率,差异均有统计学意义(P<0.05)。治愈44例(100%),无死亡病例。结论:永州市新冠肺炎重型及危重型患者比轻型及普通型患者更易出现白细胞计数升高,中性粒细胞计数增多,淋巴细胞计数减少及CT病变为多叶病灶;更易发生低钾血症及谷草转氨酶升高;抗生素、激素、免疫球蛋白和无创呼吸机使用率高。

Objective:To analyze the general situation and clinical characteristics of coronavirus disease 2019(COVID-2019)in Yongzhou city and provide reference for COVID-2019 control.Methods:A total of 44 patients with COVID-2019 admitted in Yongzhou central hospital were included in the study.According to the clinical classification,the patients were divided into two groups mild and moderate group(MM group,32 cases),severe and critical group(SC group,12 cases).The general situation,epidemiology,clinical symptoms,medical history and complications,laboratory examination,imaging characteristics and treatment plan of the two groups were compared and analyzed,and the clinical characteristics,treatment process and prognosis were summarized.Results:There was no significant difference between mild and moderate group and severe and critical group in age,gender,definite incubation period or definite infection transmission generations(P>0.05).Compared with MM group,SC group needs longer hospitalization time(P<0.05).There was no significant difference between the two groups in clinical symptoms of fever,cough,fatigue,pharyngeal pain,nasal obstruction,runny nose,diarrhea,history of hypertension or diabetes(each P>0.05),Compared with MM group,SC group had higher proportion of hypokalemia and AST increase(P<0.05).There was no significant difference in hypoproteinemia,elevated ALT,respiratory failure or heart failure(each P>0.05).Compared with MM group,SC group had higher WBC count,higher neutrophil count,lower lymphocyte count and more multileaf lesions in the laboratory and CT results(P<0.05).There was no significant difference between the two groups in decrease of leukocyte count,neutrophil count,eosinophil count,increase of C-reactive protein,ESR,LDH,ground glass or subpleural or extrapulmonary zone were the main pathological changes of CT(each P>0.05).Compared with MM group,SC group were different in the use rate of antibiotics,glucocorticoids,immunoglobulin and noninvasive ventilator in the treatment plan(P<0.05).Totally 44 cases(100%)were cured without death.Conclusion:Compared with MM group,SC group is more likely to have increased leukocyte count,increased neutrophil count,decreased lymphocyte count and CT lesions with multileaf focus,more likely to have hypokalemia and increased AST,more likely to use antibiotics,glucocorticoids,immunoglobulins and non-invasive ventilator.