伴与不伴糖尿病的新型冠状病毒肺炎患者实验室指标及预后的差异分析

Differences in Laboratory Indicators and Prognosis Between COVID-19 Patients with or without Diabetes Mellitus

目的分析伴与不伴糖尿病新型冠状病毒肺炎患者的实验室指标及疾病转归的差异。方法纳入2020年1月13日至2020年2月12日我院收治的新型冠状病毒肺炎(COVID-19)患者共63例作为研究对象,依据有无合并糖尿病分为糖尿病组和非糖尿病组。比较两组患者C反应蛋白、血清淀粉样蛋白、淋巴细胞亚群计数、丙氨酸氨基转移酶、乳酸脱氢酶等实验室指标以及肺外器官功能异常比例、临床转归的差异。结果糖尿病组年龄明显大于非糖尿病组,C反应蛋白及血清淀粉样蛋白高于非糖尿病组(P<0.05)。糖尿病组CD3+CD8+T、B细胞计数明显低于非糖尿病组(P<0.05);糖尿病组CD3+CD4+T、NK细胞计数中位数低于非糖尿病组,但差异无统计学意义(P>0.05)。糖尿病组危重症患者比例明显高于非糖尿病组,肺外脏器功能损害更常见,核酸转阴时间及住院时间更长(P<0.05)。结论糖尿病患者是感染COVID-19的高危人群中位数值。COVID-19合并糖尿病患者年龄更大,重症比例更高,肺外脏器功能损害更常见,住院时间更长,死亡风险大。COVID-19合并糖尿病者在住院期间更宜使用胰岛素控制血糖。

Objective To analyze the differences in laboratory parameters and disease pregnosis between COVID-19 patients with diabetes mellitus and without diabetes mellitus.Methods A total of 63 patients with COVID-19 admitted to our hospital from January 13,2020 to February 12,2020 were included as research objects,they were divided into diabetic group and non-diabetic group.Differences in laboratory parameters such as C-reactive protein,serum amyloid,lymphocyte subsets,alanine aminotransferase,and lactate dehydrogenase,as well as the proportion of abnormal organ function and clinical outcomes were compared between the two groups.Results The age of the diabetic group was significantly older than that of the non-diabetic group,and the C-reactive protein,serum amyloid protein were higher than those of the non-diabetic group(P<0.05).The CD3+CD8+T and B cell counts in the diabetic group were significantly lower than those in the non-diabetic group(P<0.05);the median CD3+CD4+T and NK cell counts in the diabetic group were lower than those in the non-diabetic group,but the difference was not statistically significant(P>0.05).The proportion of critically ill patients in the diabetic group was significantly higher than that in the non-diabetic group(P<0.05).In the diabetic group,the dysfunction of external pulmonary organs was more common,and the time of nucleic acid conversion and hospitalization was longer(P<0.05).Conclusion Patients with diabetes were at high risk of COVID-19 infection.COVID-19 patients with diabetes were older and they had a higher proportion of severe cases.Damage to organs outside the lungs was more common in COVID-19 patients with diabetes,their hospital stay was longer and risk of death was higher.COVID-19 patients with diabetes are more suitable to use insulin to control blood sugar during hospitalization.