新型冠状病毒肺炎恢复期46例临床分析

Clinical profiles of COVID-19 during convalescence:A 46-case analysis

目的:了解新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)患者恢复期的生理指标及肺脏等器官功能恢复情况。方法:2020年3月13日至3月23日本院共46例COVID-19恢复期患者在出院后第14 d接受检查,收集其随诊资料及检查结果,比较普通型及重型患者恢复期的血常规、肝肾功能、抗体产生、免疫功能、肺部CT表现以及肺功能的差异。结果:46例恢复期患者中,普通型34例,重型12例。以睡眠障碍为主诉的患者占26.09%,重型及普通型患者的白细胞计数、淋巴细胞计数、C反应蛋白、白介素6、肝功能、肾功能两组数据相比差异无统计学意义(P>0.05);重型患者的血浆白蛋白比普通型患者低,但均在正常范围;重型患者的B淋巴细胞计数低于普通型患者,分别为111.5(47.3~194.0)个/μl以及165.5(122.8~252.8)个/μl,两者差异有统计学意义(P<0.05);重型患者的肺内残留病变范围较普通型患者更广(P<0.05);重型患者较多表现为轻度、中度弥散功能下降,两组比较,重型患者弥散功能下降的人数明显高于普通型组(P<0.05)。结论:COVID-19恢复期,睡眠障碍为最常见的主诉,重型患者的B淋巴细胞恢复较慢,肺内残留病变范围更大,肺弥散功能下降较为明显。

Objective:To investigate the recovery in physiology and function of the lung and other organs in patients with coronavirus pneumonia disease 2019(COVID-19)during the convalescence.Methods:A total of 46 convalescent patients with COVID-19 treated in our hospital between March 13 and March 23 of 2020 underwent follow-up examinations on day 14 post-discharge.The follow-up data and examination findings were collected.The differences in blood routine test,liver and kidney functions,antibodies,immune function,lung CT signs and pulmonary function were compared between convalescent and critically-ill patients.Results:Of the 46 patients with COVID-19,34 were previously of common type and 12 of severe type.Sleep disorders accounted for 26.09%of chief complaints in these patients.There were no significant differences in leukocytes,lymphocytes,C-reactive protein,interleukin-6,liver and renal functions between patients with previously severe and common types of COVID-19(P>0.05).Compared with common type COVID-19,the previously severe cases presented lower plasma albumin level(albeit both within normal range),and lower B-lymphocyte counts[111.5(47.3-194.0)/μl vs 165.5(122.8-252.8)/μl],with statistically significant difference(P<0.05).There was a wider distribution of residual pulmonary lesions among previously severe patients than those previously with common type COVID-19(P<0.05).Patients with previously severe type COVID-19 were more frequent to show mild to moderate decline in diffusing capacity,and were significantly more likely to show severely reduced diffusing capacity compared with the previously common type cases of COVID-19(P<0.05).Conclusion:In convalescent of COVID-19,sleep disorder is the most common complaint.Previously severe cases may experience fairly recovery of B-lymphocytes,wider distribution of residual pulmonary lesions,and more significant decline in pulmonary diffusion capacity.