新型冠状病毒肺炎危重症患者的心肺表现特征

Cardiac and lung ct imaging characteristics of critically ill patients infected with COVID-2019

目的探讨新型冠状病毒肺炎(COVID-19)危重症患者的心肺表现特征。方法回顾性研究2020年1月23日—2020年2月22日广州市第八人民医院收治的16例COVID-19危重症患者,以同期收治的29例非重症患者作为对照,比较两组患者的临床特点、心肌损伤及炎症标志物水平及CT肺部受累程度。结果COVID-19危重症组患者的年龄均值、合并症患者占比均高于对照组(P<0.05),血清乳酸脱氢酶(LDH)、血清肌红激酶(MYO)、血清肌酸激酶-MB同工酶(CK-MB)和血清C反应蛋白(CRP)峰值异常比例也均明显升高(P<0.05)。危重症组患者胸部CT肺受累评分均值高于对照组(P<0.05),平均受累面积大于50%,以双侧肺部磨玻璃样变和实变为主要特征。结论COVID-19危重症患者中高龄占比高,心肌损伤及肺部炎症受累概率增大,程度进一步加重,其肺部感染CT征象以磨玻璃影和实变影为主要特征。

Objective To study and analyze the lung and cardiac imaging characteristics of critically ill patients infected with COVID-19.Methods The clinical data of 16 critically ill patients with Covid-19 hospitalized in Guangzhou Eighth People’s Hospital from January 23 to February 22 in 2020 were retrospectively analyzed as the critically ill group,and another 29 non-critically ill patients during the same period as the controls.The two groups were compared in terms of clinical manifestations,myocardial damage,inflammatory markers,and lung CT imaging.Results The critically ill patients were significantly older than the non-critically ill by the average age(P<0.05),and they had a significantly higher rate of complications(P<0.05).The levels of serum lactate dehydrogenase(LDH),serum myoglobin kinase(MYO),serum creatine kinase MB isoenzyme(CK-MB)and serum c-reactive protein(CRP)were all significantly higher than those of the control group(P<0.05).The score of CT imaging of affected lungs in the critically ill group was significantly higher than that of the control group(P<0.05),and the average affected size in the lungs of critically ill patients was significantly larger than that of the non-critically ill patients.The most common patterns on chest CT imaging for the critically ill patients were ground-glass opacity and bilateral patchy shadowing.Conclusion Critically ill patients infected with Covid-19 are elder than the non-critically ill patients,and they are more prone to myocardial injury and severe pulmonary infection(P<0.05),with the ground-glass opacity and bilateral patchy shadowing as the most common patterns on chest CT imaging.