2019新型冠状病毒肺炎肾功能及尿常规指标分析

Renal Function and Urine Routine Indicators Analysis of Coronavirus Disease 2019

探讨肾功能指标及尿常规检测在2019新型冠状病毒肺炎(Coronavirus disease 2019,COVID-19)诊疗过程中的临床意义。收集2020年1月1日至2020年3月15日湖南省岳阳市一人民医院收治的所有COVID-19患者病例,经纳入与排除标准后,确定82例COVID-19患者作为本次研究对象。收集患者一般资料及实验室检查,根据患者病情严重程度分为轻型组(20例)、普通型组(32例)、重型组(23例)和危重型组(7例),分析各组患者基线特征,肾功能和尿常规检测相关指标异常病例比例及水平差异。从患者基线特征分析来看,各组年龄、性别比例、伴发疾病情况均无统计学差异,但各组住院时长,白细胞,丙氨酸转氨酶及白蛋白水平存在显著性统计学差异。从各组肾功能相关指标分析来看,各组血尿素氮(Blood urea nitrogen,BUN)、血清肌酐(Serum creatinine,SCR)、血清尿酸(Serum uric acid,SUA)指标升高病例比例及水平,血清胱抑素C(Cystatin C,Cys C)水平无统计学差异,但各组间的血清Cys C升高病例比例有显著性统计学差异,且危重型组升高病例比例远高于其余组。从尿常规检测相关指标分析来看,各组间的蛋白尿和尿红细胞计数的异常病例比例及水平无统计学差异。但各组间尿白细胞计数及细菌数的异常病例比例及水平具有显著性统计学差异,且均表现为危重型组异常病例比例及水平高于其余组。与SCR,BUN,SUA,蛋白尿及血尿指标相比,血清Cys C更能灵敏地反映COVID-19患者肾功能情况。并且危重型患者可能更易发生肾损伤。危重型患者尿常规中细菌数及尿白细胞计数异常病例比例和水平均高于其余组,提示危重型患者易合并尿路感染。说明肾功能指标及尿常规检测在COVID-19患者诊疗过程中具有一定的临床意义。

To explore the clinical significance of renal function indicators and urine routine test in the diagnosis and treatment of coronavirus disease 2019(COVID-19),all data of COVID-19 patients admitted to the First People’s Hospital of Yueyang City in Hunan Province,China,from January 2020 to March 15,2020 were collected. With the inclusion and exclusion criteria,82 patients with COVID-19 were identified as the research objects. we collected the general information and laboratory data of these patients,and divide them into mild group(20 cases),moderate group(32 cases),severe group(23 cases)and critical severe group(7 cases)according to the severity of these patients,and analyze the baseline characteristics of these patients,the abnormal proportion and level differences of related indicators of renal function and urine routine test among four groups. Based on the baseline characteristics of COVID-19 patients,there was no stastical difference in age,sex ratio,and concomitant diseases among these groups. But there were significant stastical differences in length of stay,and the levels of white blood cell count,alanine transaminase and albumin among these groups. Based on the analysis of renal function related indicators,the proportion of patients with elevated blood urea nitrogen(BUN),serum creatinine(SCR)and serum uric acid(SUA);and the level of BUN,SCR,SUA and serum cystatin C(Cys C)have not statistical difference,but the proportion of patients with elvated Cys C among these groups has significant statitical difference,and the proportion of critical severe group was much higher than other groups. Based on the analysis of the relevant indicators of urine routine test,there was no statistical difference in the abnormal ratio and level of urine protein,urine erythrocyte count among the groups. However,the abnormal proportion and levels of urine leukocyte count and bacterial count have statistical significant difference among these groups. In addition,the abnormal proportion and level of urine leukocyte count and bacterial count in critical severe group were more than other groups. Compared with SCR,BUN,SUA,proteinuria and hematuria,serum Cys C can more sensitively reflect renal function of COVID-19 patients. In addition,the critical severe patients may be more prone to kidney impairment. The abnormal proportion and level of urine leukocyte count and bacterial count in critical severe group were more than other groups,suggesting that the critical severe patients are susceptible to urinary tract infections. The study demonstrates that renal function indicators and urine routine test are of certain clinical significance in the diagnosis and treatment of COVID-19 patients.