四川省眉山市8例2019新型冠状病毒肺炎的临床特征及影像分析

Clinical features of eight patients with novel corona virus disease 2019 in Meishan,Sichuan province

目的了解2019新型冠状病毒肺炎(COVID-19)患者的临床特点。方法回顾性分析眉山市仁寿县人民医院2020年1月24日至2020年3月14日共8例COVID-19确诊患者的临床表现、实验室检查及影像学特征。结果8例患者中男性5例,女性3例,年龄29~63岁,中位年龄为50岁,3例有武汉地区旅居史及确诊患者接触史,4例为两起家庭聚集性发病,潜伏期为7~20d,中位数14d,临床表现为发热、咳嗽7例(87.5%)、头痛、乏力、腹泻各3例(37.5%),口干、头昏、食欲减退各2例(25%),鼻塞流涕、膝关节疼痛各1例(12.5%),气促1例(12.5%)。2例患者有基础疾病(分别为糖尿病、甲状腺功能亢进)。实验室检查方面,8例患者外周血白细胞计数均正常,3例淋巴细胞数减少,2例降钙素原轻度升高,所有患者甘油三脂均有不同程度的升高。胸部CT主要以单侧肺及双肺斑片状、磨玻璃影、间质性改变为主,累及双肺6例、累及单侧肺2例,以右肺为主。所有患者均以干扰素-α及洛匹那韦/利托那韦片抗病毒治疗,5例继发细菌感染给予抗菌药物治疗。到目前为止,8例患者全部治愈出院,其中1例患者新冠病毒核酸持续阳性(33d/6次深部痰液呼吸道标本监测)。结论本地区所有COVID-19患者均为普通型,大多具有明确流行病学史,以输入型为主,胸部影像大多为典型的病毒性肺炎表现,新型冠状病毒核酸检测持续阳性的原因目前尚未明确,尚需对新冠病毒的致病特点进一步观察及研究。

Objective To study the clinical characteristics of the patients with novel corona virus disease 2019(COVID-2019).Methods Clinical manifestations,blood tests and CT imaging characteristics of the eight confirmed cases in Renshou County People’s hospital from January 24,2020 to March 14,2020 were retrospectively analyzed.Results Of the eight patients,five were males and three were females(age range:29~63 years).Three patients had contact with residents of Wuhan or other confirmed cases,and four patients from two cases were infected due to households clustering.The median of incubation period was 14 days(period range:7~20 days).The clinical manifestations included fever and cough(7,87.5%),headache(3,37.5%),fatigue(3,37.5%),diarrhea(3,37.5%),dry mouth(2,25%),dizziness(2,25%),loss of appetite(2,25%),nasal congestion and runny nose(1,12.5%),knee pain(1,12.5%)and shortness of breath(1,12.5%).Two patients had underlying diseases(diabetes and hyperthyroidism respectively).In terms of blood tests,eight cases had normal peripheral blood white blood cell counts,three cases had decreased lymphocyte counts.Slightly increased procalcitonin(PCT)were found in two cases.All the patients had increased triglyceride(TG).Chest CT showed patchy,ground glass shadow(GGO),and interstitial changes in unilateral and bilateral lungs,including six cases of bilateral lung and two cases of unilateral lung,mainly in the right lung.All the patients were treated with interferon-alpha and lopinavir/ritonavir,and five cases with secondary bacterial infection were treated with antibiotics.Up to now,eight patients were cured and discharged.Nucleic acid continued to be positive in one patient(standard monitoring ofsix deep sputum respiratory tracts in 33 days).Conclusion In this study,all the patients were common type of COVID-2019,most of them were imported cases with clear epidemiological history.Chest imaging showed the general characteristics of viral pneumonia.The reason for the continuous positive nucleic acid test of SARS-CoV-2 has not been clarified.The pathogenic characteristics of COVID-2019 need to be further studied.