苏州地区87例新型冠状病毒肺炎患者发病早期的临床资料分析及其治疗对策

Analysis on Clinical Data of 87 Patients with Early Stage of COVID-19 in Suzhou Area and Its Therapeutic Countermeasures

目的:分析苏州地区被确诊为新型冠状病毒肺炎(COVID-19)患者发病早期的临床资料及其治疗策略,为临床判断其病情进展和早期治疗提供参考。方法:收集2020年1月13日—3月1日期间收治的87例被确诊为COVID-19患者临床资料,分析其患者发病早期的临床表现、实验室指标以及治疗措施。结果:87例COVID-19患者资料中,有湖北旅居史者50例(57.47%),无湖北旅居史者37例(42.53%);其中常见症状有发热者72例(82.76%)、咳嗽54例(62.07%)、乏力40例(45.98%)、鼻咽部不适(包括鼻塞、流涕、咽干、咽痛)30例(34.48%)和呼吸困难5例(5.75%);病情程度为轻型10例(11.49%)、普通型66例(75.86%)、重型10例(11.47%)和危重型1例(1.15%);轻型及普通型组和重型及危重型组患者的实验室指标中单核细胞、C反应蛋白、谷草转氨酶、D-二聚体等指标测得值经比较其差异有统计学意义(P<0.05)。结论:在COVID-19发病早期患者有呼吸困难症状、鼻咽部无不适症状表现,以及单核细胞、C反应蛋白、谷丙转氨酶、D-二聚体水平高表达与淋巴细胞、嗜酸性粒细胞等指标的低表达患者,其病情更易加重;通过对上述指标的变化,早期干预,控制其炎症反应,改善预后,可降低其病死率。

Objective: To analyze the early clinical data of patients diagnosed with COVID-19 in Suzhou area and its therapeutic countermeasures, and to provides reference for clinical judgement of the disease progression and early treatment. Methods: Clinical data were collected from 87 patients diagnosed with COVID-19 admitted from January 13 to March 1, 2020, the early clinical manifestations, laboratory indicators and treatment measures were analyzed. Results:Among the 87 patients with COVID-19, 50(57.47%) and 37(42.53%) had no history of travel in Hubei. There were 72 cases(82.76%) with fever, 54 cases(62.07%) with cough, 40 cases(45.98%) with fatigue, 30 cases(34.48%) with nasopharyngeal discomfort(including nasal congestion, runny nose, dry pharynx and sore throat) and 5 cases(5.75%) with dyspnea.There were 10 mild cases(11.49%), 66 ordinary cases(75.86%), 10 severe cases(11.47%) and 1 critical case(1.15%). The values of monocytes, CRP, glutamine transaminase and D-dimer were higher than those of lymphocytes and eosinophils(P<0.05). Conclusion: Patients with dyspnea and nasopharyngeal discomfort in the early stage of COVID-19, as well as patients with high expression levels of monocytes, CRP, ALT, D-dimer and low expression levels of lymphocyte, eosinophilic granulocyte and other indicators, were more likely to worsen their condition. Through the changes of the above indicators, early intervention, control of its inflammatory response, improved the prognosis, could reduce its mortality.