不同分型新型冠状病毒肺炎患者的临床特点分析

Analysis of clinical characteristics of patients with different types of coronavirus disease 2019

目的了解不同分型新型冠状病毒肺炎(COVID-19)患者的临床特点。方法回顾性分析2020年1月22日至2月15日广州医科大学附属第八人民医院收治的272例COVID-19患者的一般情况、首次实验室检查指标和影像学资料。依据临床分型分为非重症组(轻型+普通型)236例和重症组(重型+危重型)36例。组间比较采用t检验、χ^2检验或秩和检验。结果重症组36例患者中,男23例,女13例;非重症组236例患者中,男103例,女133例,两组性别差异有统计学意义(χ^2=5.149,P=0.023);重症组年龄为(60.5±11.2)岁,大于非重症组的(46.8±15.7)岁,差异有统计学意义(t=6.43,P<0.01)。重症组血淋巴细胞计数、血小板计数、动脉血氧分压分别为0.90(0.55,1.10)×109/L、170.00(143.50,198.00)×109/L、73.50(69.70,83.00)mmHg(1 mmHg=0.133 kPa),分别低于非重症组的1.42(1.09,1.95)×109/L、187.00(148.00,230.00)×109/L、96.00(83.20,108.00)mmHg,差异均有统计学意义(Z=5.59、2.00、5.00,均P<0.05);重症组肌酸激酶、天冬氨酸转氨酶、乳酸脱氢酶、C反应蛋白、降钙素原分别为123.00(79.00,212.00)U/L、32.10(27.00,47.40)U/L、305.50(216.00,396.00)U/L、37.02(23.92,63.66)mg/L、0.09(0.05,0.19)μg/L,分别高于非重症组的68.00(48.00,103.00)U/L、20.10(16.70,26.20)U/L、179.00(150.00,222.00)U/L、26.55(18.11,36.96)mg/L、0.04(0.03,0.06)μg/L,差异均有统计学意义(Z=3.89、5.60、5.12、2.85、5.43,均P<0.01);两组间白细胞计数、肌酸激酶同工酶、血乳酸差异均无统计学意义(Z=1.53、0.41、1.00,均P>0.05)。结论性别、年龄、血淋巴细胞计数、血小板计数、动脉血氧分压、肌酸激酶、天冬氨酸转氨酶、乳酸脱氢酶、C反应蛋白、降钙素原等指标可为临床分型提供有价值的参考。

Objective To analyze the clinical characteristics of patients with different types of coronavirus disease 2019(COVID-19).Methods A total of 272 eligible COVID-19 patients who were admitted to Guangzhou Eighth People′s Hospital,Guangzhou Medical University from January 22 to February 15,2020 were retrospectively enrolled.General characteristics,the first laboratory examination and imaging data of these patients were collected.According to the clinical classification,there were 236 cases in non-severe group(mild+common type)and 36 cases in severe group(severe+critical type).Comparisons between groups were performed by t test,chi-square test or rank-sum test when appropriate.Results There were 23 males and 13 females in the severe group,103 males and 133 females in the non-severe group,and the difference was statistically significant(χ2=5.149,P=0.023).The age of severe group was(60.5±11.2)years,which was higher than that of non-severe group(46.8±15.7)years.The difference was statistically significant(t=6.43,P<0.01).The lymphocyte(LYM)count,platelet(PLT)count and arterial partial pressure of oxygen(PaO2)in the severe group were 0.90(0.55,1.10)×109/L,170.00(143.50,198.00)×109/L and 73.50(69.70,83.00)mmHg(1 mmHg=0.133 kPa),respectively,which were all lower than those in the non-severe group(1.42(1.09,1.95)×109/L,187.00(148.00,230.00)×109/L and 96.00(83.20,108.00)mmHg,respectively).The differences were all statistically significant(Z=5.59,2.00 and 5.00,respectively,all P<0.05).The levels of creatine kinase(CK),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),C reaction protein(CRP)and procalcitonin(PCT)in the severe group were 123.00(79.00,212.00)U/L,32.10(27.00,47.40)U/L,305.50(216.00,396.00)U/L,37.02(23.92,63.66)mg/L and 0.09(0.05,0.19)μg/L,respectively,which were all higher than those in the non-severe group(68.00(48.00,103.00)U/L,20.10(16.70,26.20)U/L,179.00(150.00,222.00)U/L,26.55(18.11,36.96)mg/L and 0.04(0.03,0.06)μg/L respectively),and the differences were all statistically significant(Z=3.89,5.60,5.12,2.85 and 5.43,respectively,all P<0.01).No significant differences were observed in white blood cell count,creatine kinase isoenzyme and blood lactate between the two groups(Z=1.53,0.41 and 1.00,respectively,all P>0.05).Conclusion Gender,age,LYM count,PLT count,PaO2,CK,AST,LDH,CRP and PCT could be used to provide reference for clinical classification of COVID-19 patients.