新型冠状病毒肺炎的临床特征及CT影像表现

Clinical Features and CT Imaging Findings of Patients with Corona Virus Disease-19

目的:探讨新型冠状病毒(COVID-19)患者治疗前后的临床特征以及影像表现。方法:选取2019年12月至2020年3月在南通大学附属南通第三医院收治的30例COVID-19患者作为研究对象,对其入院治疗前后的临床症状、实验室指标及CT影像学表现进行分析。结果:入组患者中,发热者占83.3%,胸闷气促者占23.3%,头痛占10%,肌肉酸痛占10%,低氧血症占7%;实验室检查中,淋巴细胞计数、淋巴细胞百分比、C反应蛋白、肌酸激酶及谷丙转氨酶治疗前后的差异具有统计学差异(P<0.05);CT表现肺内无病变者占6.7%,呈单纯磨玻璃样影者占16.7%,呈混合型改变者占76.7%,其中磨玻璃影伴局部实变占23.3%,磨玻璃影伴纤维化灶占20%,磨玻璃影伴局灶实变及纤维化灶占30%,病灶周围出现晕征占40%,小叶间隔增厚占20%,病灶内血管增粗者占23.3%,病灶内出现充气支气管征占30%。结论:COVID-19的主要临床症状为发热、咳嗽;实验室检查包括白细胞计数减低,淋巴细胞百分比下降,血沉加快;胸部影像表现为片絮状磨玻璃影,可合并实变及纤维化。

Objective: To analyze clinical features and imaging findings of patients with Novel coronavirus pneumonia before and after treatment. Methods: 30 patients with confirmed as Novel coronavirus pneumonia from December 2019 to March 2020 in the Third Hospital Affiliated of Nantong University were enrolled as the subjects of this study. There clinical symptoms, laboratory examination indexes and CT imaging findings were analyzed before and after treatment. Results: 83.3% of the included patients had a fever, 23.3% had chest distress and shortness of breath, 10% had headache, 10% had muscle ache, and 7% had hypoxemia. Laboratory studies showed that there were significant differences in lymphocyte count, lymphocyte percentage, C-reactive protein, creatine kinase and glutamic pyruvic transaminase before and after treatment(P<0.05);CT findings showed that 6.7% of these patients had no pathological changes,16.7% of them had ground glass shadow only, 76.7% of them had mixed changes, of which 23.3% had ground glass shadow with local consolidation, 20% had ground glass shadow with fibrosis, 30% had ground glass shadow with local consolidation and fibrosis, 40% had halo sign around the lesion, 2% had thickening of interlobular septum, 23.3% had thickening of blood vessels in the lesion, and 30% had air filled bronchi sign in the lesion. Conclusion: Novel coronavirus pneumonia is characterized by fever and cough;abnomal laboratory examinations include decreased white blood cell count, decreased lymphocyte percentage and increased erythrocyte sedimentation rate;The chest image shows flocculent ground glass shadow, which can be combined with consolidation and fibrosis.