温州地区140例新型冠状病毒肺炎患者的临床特征分析

Clinical characteristics of COVID-19:A retrospective analysis of 140 patients in Wenzhou,China

目的探讨温州地区实验室确诊的新型冠状病毒肺炎患者的临床特点。方法回顾性分析我院2020年1月至3月收治的140例新型冠状病毒肺炎患者的临床表现、实验室检查和影像学分析及治疗药物等,同时按病情严重程度分为非严重组和严重组,比较两组在临床特点、影像学和实验室主要指标的差异。结果140例新型冠状病毒肺炎患者中男性75例、女性65例,平均年龄(45.38±14.58)岁,常见症状为发热伴咳嗽、咳痰,8例患者表现为无症状感染,但是COVID-19 RNA阳性。病情严重程度以轻症居多(114例),占81.42%,重症26例,占18.58%。严重组患者的淋巴细胞计数、血小板计数、谷草转氨酶、乳酸脱氢酶、总蛋白、前白蛋白、血尿酸、C反应蛋白、血沉、动脉血氧分压、氧合指数等与非严重组比较,差异均有统计学意义(t分别=5.54、2.41、-3.22、-6.85、4.42、6.96、2.38、-8.08、-3.04、2.62、4.89,P均<0.05)。影像学上两肺及多叶受累,表现以不规则斑片状影和磨玻璃影为主,呈现多灶性和多样性特点。治疗上以低流量给氧为主,个别病例需无创性机械通气,尚未使用体外膜肺氧合技术。抗病毒药物使用占90.00%,使用糖皮质激素患者占25.72%,总体预后良好,治愈率100%。结论温州地区新型冠状病毒肺炎患者大多表现为普通型,主要累及呼吸道,相对武汉感染者,病情轻,死亡率低,总体预后良好。

Objective To explore the clinical characteristics of confirmed COVID-19 in Wenzhou.Methods The clinical data of 140 COVID-19 patients treated from January 2020 to March 2020 in our hospital were retrospectively collected.The clinical characteristics,images were compared between patients with mild illness and those with severe illness.Results There were 75 male patients and 65 female patients.The mean age was 45.38±14.58.The most common symptom was fever,followed by cough.Eight patients were asymptomatic but COVID-19 RNA was positive.Most of the patients had mild illness which account for 81.42%and 26 patients had severe illness(18.58%).There were significant differences between two groups in the blood lymphocyte count,platelet count,aspartate aminotransferase,lactate dehydrogenase,total protein,prealbumin,blood uric acid,CRP,ESR,arterial partial pressure of oxygen and oxygenation index(t=5.54,2.41,-3.22,-6.85,4.42,6.96,2.38,-8.08,-3.04,2.62,4.89,P<0.05).The two lungs and multiple lobes were affected,and the manifestations were mainly irregular patchy shadows and ground glass shadows,showing the characteristics of multifocality and diversity.The treatment was based on low-flow oxygen.Some cases required non-invasive mechanical ventilationm,but ECMO has not been used.90.00%patients were treated by antiviral drugs,and 25.72%patients were treated by glucocorticoid.The prognosis of these patients was good,the cure rate was 100%.Conclusion Most patients diagnosed with COVID-19 in Wenzhou has mild illness,and the respiratory tract were mainly involved.Compared with those COVID-19 in Wuhan,the severity in Wenzhou is milder,the mortality rate is lower,the prognosis is good.