普通型和重型新型冠状病毒肺炎患者炎症指标和心肌酶谱比较

Comparative of inflammatory markers and myocardial enzymes in patients with common and severe COVID-19

目的比较普通型和重型新型冠状病毒肺炎(COVID-19)患者炎症指标和心肌酶特点。方法本研究是一项回顾性横断面研究。根据患者临床病情分型,连续纳入2020年1~2月来自武汉市黄陂方舱医院和黄陂区人民医院普通型和重型COVID-19患者共128例,其中普通型组84例,重型组44例。收集所有患者的临床资料、既往病史、炎症指标、心肌酶谱[乳酸脱氢酶(LDH)、肌酸激酶(CK)及其同功酶(CK-MB)、肌红蛋白(Mb)]和高敏肌钙蛋白I(hs-cTnI)等资料并进行比较分析。结果重型组患者的年龄、体温、呼吸次数、脉搏、舒张压、谷草转氨酶、尿素氮和肺部病变范围明显高于普通型组;血氧饱和度则明显低于普通型组,差异均有统计学意义(P<0.05);重型组患者的白细胞计数、中性粒细胞百分比、超敏C反应蛋白和血清淀粉样蛋白A明显高于普通型组,而淋巴细胞计数和淋巴细胞百分比则明显低于普通型组,差异均有统计学意义(P<0.05);重型组患者的CK、LDH、Mb和hs-cTnI水平明显高于普通型组,差异均有统计学意义(P<0.05)。结论重型COVID-19患者炎症指标和心肌酶谱变化比普通型患者更显著。

Objective To analyze the inflammatory markers and myocardial enzymes in patients with common and severe COVID-19.Methods This study was a retrospective cross-sectional study.According to the clinical classification of the patients,a total of 128 common and severe COVID-19 patients,who admitted to Wuhan Huangpi Square Hospital and Wuhan Huangpi District People's Hospital from January to February 2020 were included,including 84 patients with common COVID-19 and 44 patients with severe COVID-19.The clinical data,previous medical history,inflammatory indicators,myocardial enzyme profile including lactic dehydrogenase(LDH)and creatine kinase(CK),creatine kinase-MB fraction(CK-MB),myoglobin(Mb)and high-sensitive cardiac troponin I(hs-cTnI)were collected for all patients.Results The results showed that age,temperature,breathing rate,pulse,diastolic blood pressure,aspertate aminotransferase,urea nitrogen,and scope of lung lesions in the severe group were significantly higher than those in common group(all P<0.05);while the blood oxygen saturation is significantly lower than that in the common group(P<0.05).The white blood cell count,neutrophil percentage,hypersensitive C-reactive protein and serum amyloid A in the severe group were all significantly higher than those in the common group,while the lymphocyte count and lymphocyte percentage in the severe group were significantly lower than those in the common group(all P<0.05).CK,LDH,Mb,and hs-cTnI in the severe group were all significantly higher than those in the common group(all P<0.05).Conclusion Changes in inflammatory markers and myocardial enzymes in patients with severe COVID-19 were more significant than those in patients with common COVID-19.