炎症指标及血常规在新型冠状病毒肺炎患者病程中的水平变化及应用价值

Level changes and application value of inflammatory indicators and blood routine in the course of patients with Corona Virus Disease 2019

目的探讨炎症指标及血常规在新型冠状病毒肺炎(COVID-19)患者病程中的水平变化及应用价值。方法选取145例COVID-19确诊患者作为确诊组,根据COVID-19临床分型标准又将确诊组患者分为普通型组113例,重型组27例,危重型组5例。另选取84例在发热门诊就诊和在隔离病区观察,且已排除COVID-19的患者作为对照组。比较不同临床分型患者在疾病不同时期的血常规、炎症指标;分析合并呼吸道细菌感染的COVID-19患者血常规、炎症指标在疾病不同时期的变化情况。结果与对照组比较,确诊组白细胞计数(WBC)、中性粒细胞计数(NEUT)和淋巴细胞计数(LYM)水平明显降低(P<0.05),C反应蛋白(CRP)和血清淀粉样蛋白A(SAA)水平明显升高(P<0.05)。普通型组与重型组转归期WBC、LYM水平较急性期升高(P<0.05)。普通型组转归期CRP、SAA水平明显低于急性期(P<0.05);重型组恢复期CRP和SAA水平低于转归期与急性期(P<0.05),转归期CRP和SAA水平低于急性期(P<0.05)。4例合并呼吸道细菌感染的COVID-19患者WBC、NEUT、LYM、CRP及降钙素原水平在加重期升高,恢复期下降,SAA水平则呈逐渐下降趋势。结论LYM、WBC、CRP和SAA水平在一定程度上可反映COVID-19不同分型患者的疾病转归情况及治疗效果。危重型、重型COVID-19患者容易合并呼吸道细菌感染。

Objective To explore the level changes and application value of inflammatory indicators and blood routine in the course of patients with Corona Virus Disease 2019(COVID-19).Methods Selected 145 confirmed COVID-19 patients as the confirmed group.According to the COVID-19 clinical classification criteria,patients in the confirmed group were divided into 113 cases in the general group,27 cases in the severe group,and 5 cases in the critical group.In addition,84 patients who visited the fever clinic and observed in the isolation ward,and who had excluded COVID-19 were selected as the control group.Compared the blood routine and inflammation indicators of patients with different clinical types at different stages of the disease.Analyzed the changes of blood routine and inflammatory indicators of COVID-19 patients with respiratory bacterial infection in different periods of the disease.Results Compared with the control group,the white blood cell count(WBC),neutrophil count(NEUT)and lymphocyte count(LYM)levels in the confirmed group were significantly reduced(P<0.05),C-reactive protein(CRP)and serum amyloid A(SAA)levels were significantly increased(P<0.05).The levels of WBC and LYM in the general group and severe group were higher in transition period than those in acute period(P<0.05).The levels of CRP and SAA in the general group were higher in transition period than those in acute period(P<0.05).The levels of CRP and SAA in the severe group were lower in recovery period than those in transition period and acute period(P<0.05),and the levels of CRP and SAA in transition period were lower than those in acute period(P<0.05).The levels of WBC,NEUT,LYM,CRP and procalcitonin in 4 COVID-19 patients with respiratory bacterial infection increased in aggravation stage and decreased in recovery stage,while the level of SAA showed a gradual decline trend.Conclusion The levels of LYM,WBC,CRP and SAA can reflect the disease outcome and treatment effect of patients with different types of COVID-19.Critical and severe COVID-19 patients are prone to combine with respiratory bacterial infections.