92例新型冠状病毒肺炎患者临床症状及实验室检测指标分析

Analysis of clinical symptoms and laboratory determination results of 92 patients with COVID-19

目的对新型冠状病毒肺炎(COVID-19)患者的临床特征及实验室检测结果进行分析。方法回顾性分析92例COVID-19患者的发病症状、临床诊断及临床分型等病史资料及患者首次实验室检测结果[白细胞(WBC)计数、中性粒细胞绝对数(NEUT#)、淋巴细胞绝对数(LYMPH#)、CD3+细胞、CD4+细胞、CD8+细胞、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)和肺炎支原体(MP)抗体]。结果92例COVID-19患者中重症患者35例、轻症患者57例。就诊症状主要为发热(77.2%)、咳嗽(66.3%)和全身乏力(26.1%),其中咳嗽以咳白色泡沫痰(41.0%)和干咳(36.1%)为主;首发症状以仅咳嗽和发热伴咳嗽多见。有80.7%的患者WBC计数正常、84.2%的患者NEUT#正常、80.7%的患者LYMPH#正常。分别有59.3%、56.0%和51.6%的患者CD3+细胞、CD4+细胞、CD8+细胞降低。有64.1%的患者CRP升高,有72.8%的患者SAA升高,有55.7%的患者MP抗体阳性。重症组NEUT#、CRP、SAA高于轻症组(P<0.05),LYMPH#和CD3+细胞、CD4+细胞、CD8+细胞低于轻症组(P<0.05)。结论临床应警惕首发症状为咳嗽不发热或先咳嗽后发热的患者。实验室相关指标(NEUT#、LYMPH#、CRP、SAA、CD3+细胞、CD4+细胞及CD8+细胞)有助于识别重症患者。

Objective To analyze the clinical symptoms and laboratory determination results of 92 patients with corona virus disease 2019(COVID-19).Methods The clinical symptoms,diagnosis and classification data of 92 patients with COVID-19 were analyzed retrospectively.The results of the first-time laboratory determination results[white blood cell(WBC)count,the absolute value of neutrophil(NEUT#),the absolute value of lymphocyte(LYMPH#),CD3+cell,CD4+cell,CD8+cell,C-reactive protein(CRP),serum amyloid A(SAA)and Mycoplasma pneumoniae(MP)antibody]were collected.Results Among the 92 patients,there were 35 patients in severe group and 57 patients in mild group.The clinical symptoms of visit were mainly fever(77.2%),cough(66.3%)and general fatigue(26.1%),of which cough was mainly coughing white foamy sputum(41.0%)and dry cough(36.1%).The first clinical symptoms were cough and fever with cough.Totally,80.7%patients had normal WBC count,84.2%had normal NEUT#,and 80.7%had normal LYMPH#.CD3+cell,CD4+cell and CD8+cell decreased in 59.3%,56.0%and 51.6%patients,respectively.CRP was increased in 64.1%patients,SAA was increased in 72.8%patients,and MP antibody was positive in 55.7%patients.NEUT#,CRP and SAA in severe group were higher than those in mild group(P<0.05),and LYMPH#and CD3+cell,CD4+cell and CD8+cell were lower(P<0.05).Conclusions It is necessary to be alert to patients whose the first clinical symptom is only cough without fever or cough first and then fever.Laboratory determination indicators(NEUT#,LYMPH#,CRP,SAA,CD3+cell,CD4+cell and CD8+cell)can help clinicians to identify critically ill patients as soon as possible.