新型冠状病毒54例临床特征及实验室检查分析

Clinical characteristics and laboratory examination in 54 cases of corona virus disease 19

目的:探讨新型冠状病毒肺炎(COVID-19)不同严重程度患者的临床特征及实验室检查特点。方法:回顾性分析2020年1月29日至2020年2月29日收治于华中科技大学同济医学院附属协和医院西院3病区的经首都医科大学附属北京友谊医院援鄂医疗队治疗的COVID-19患者的临床资料,总结其临床特征及实验室检查特点。结果:与轻症组患者相比,重症组患者淋巴细胞计数(P=0.035)、嗜酸性粒细胞计数(P=0.025)、前白蛋白(PA)(P=0.046)显著降低;白细胞计数(P=0.007)、中性粒细胞计数(P=0.001)、ALT(P=0.041)、Cr(P=0.014)、BUN(P=0.021)、LDH(P=0.037)、CRP(P=0.046)明显升高。血清LDH升高(>245U/L)与病情严重程度显著相关(χ^2=7.687,P=0.006)。比较两组患者入院后第7日实验室检查结果,与轻症组患者相比,重症组患者淋巴细胞计数(P=0.044)、PA(P=0.006)明显降低;LDH(P=0.009)、CRP(P=0.000)、部分活化凝血酶原时间(APTT)(P=0.034)、CK(P=0.037)显著升高。血清CRP升高(>8 mg/L)(χ^2=6.949,P=0.008)及PA降低(<150 mg/L)(χ^2=4.206,P=0.040)与病情严重程度显著相关。结论:血清LDH、CRP、PA水平与COVID-19病情严重程度密切相关。与轻症患者相比,重症患者入院时更易出现血清LDH水平升高,而随疾病进展,血清CRP水平升高及PA水平降低可以提示病情严重程度,指导治疗。

Objective: To investigate the clinical characteristics and laboratory examination characteristics of corona virus disease 19(COVID-19) patients with different severity. Methods: Retrospective analysis was made on the clinical data of COVID-19 patients admitted to ward 3, west hospital, Union Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology from January 29, 2020 to February 29, 2020, and their clinical characteristics and laboratory examination characteristics were summarized. Results: Compared with the mild group, the lymphocyte count(P=0.035), eosinophil count(P=0.025) and prealbumin(PA)(P=0.046) were significantly decreased in the severe group, while the leukocyte count(P=0.007), neutrophil count(P=0.001), ALT(P=0.041), Cr(P=0.014), BUN(P=0.021), LDH(P=0.037) and CRP(P=0.046) increased obviously in the severe group. Elevated serum LDH(>245 U/L) was significantly correlated with disease severity(χ~2=7.687,P=0.006). Compared with the result of laboratory examination on the 7 th day after admission, the lymphocyte count(P=0.044) and PA(P=0.006) of the patients in the severe group were significantly reduced compared with those in the mild group, while LDH(P=0.009), CRP(P=0.000), activated partial thromboplastin time(APTT)(P=0.034)and creatine kinase(CK)(P=0.037) were significantly increased. Increased serum CRP(>8 mg/L)(χ~22=6.949,P=0.008) and decreased serum PA(<150 mg/L)(χ~2=4.206,P=0.040) were significantly correlated with disease severity. Conclusions: Serum LDH, CRP and PA levels were closely related to the severity of COVID-19. Compared with mild patients, severe patients are more likely to have increased serum LDH level when they are admitted to the hospital, and with the progression of the disease, increased serum CRP level and decreased serum PA level can indicate the severity of the disease and guide the treatment.