新冠肺炎患者总病程及影响因素分析

Analysis of the total course of novel coronavirus pneumonia patients and its influencing factors

目的研究影响新冠肺炎总病程长短的因素。方法收集2020年1-3月收治的70例新冠肺炎患者的临床资料,对其性别、年龄、从感染到发病时间、住院时间、发病前2周内是否规范使用抗病毒药物治疗及治疗种类、病程中最低淋巴细胞计数、最高C反应蛋白、病程中核酸检测阳性的次数、是否合并其他基础疾病等进行分析,对上述影响因素进行单因素回归分析,再进行线性回归分析,建立logistic多因素回归模型。结果患者感染至发病时间、发病前2周内是否规范使用抗病毒药物治疗及治疗种类、病程中最低淋巴细胞计数、最高C反应蛋白、病程中核酸检测阳性的次数为新冠肺炎患者病程发展的危险因素(OR=1.000,P<0.05)。患者多因素回归模型结果显示,患者感染到发病时间越短,患者患病严重程度越高(OR=1.141,P=0.007);患者发病前2周内规范使用抗病毒药物治疗越多,患者病程中病情越轻(OR=0.991,P<0.001);患者病程中最低淋巴细胞计数越低,患者病情越严重(OR=0.062,P<0.001);患者病程中C反应蛋白水平越高,患者病情越严重(OR=0.266,P<0.001);患者病程中核酸检测阳性的次数越多,患者病情越严重(OR=1.135,P=0.005)。结论新冠肺炎患者在其疾病发展过程中,患者感染住院至发病时间、发病前2周内是否规范使用抗病毒药物治疗及治疗种类、病程中最低淋巴细胞计数、最高C反应蛋白、病程中核酸检测阳性的次数对患者影响最大,可判断为影响因素。

Objective To analyze the novel coronavirus pneumonia patients′total disease duration and the influencing factors.Methods The clinical data of 70 patients with COVID-19 were retrospectively analyzed.The patients′gender,age,time from infection to onset,length of hospital stay,standard use of antiviral drugs within 2 weeks before the onset of the disease and treatment types,minimum lymphocyte count,maximum C-reactive protein(CRP)and nucleic acid in the course of disease,the number of positive detection,whether combined with other basic diseases were analyzed.The single factor regression analysis was conducted for the above influencing factors,and then the linear regression analysis was conducted to establish the logistic multiple factor regression model.Results A total of novel coronavirus pneumonia patients were included in the study.70 patients were retrospectively analyzed.The data showed that the time of infection to the onset of disease,the 2 weeks before onset,whether the standardized use of antiviral drugs and the type of treatment,the lowest lymphocyte count,the highest CRP,and the number of positive nucleic acid tests in the course of disease were the factors influencing the duration of the disease in the new crown pneumonia(OR=1.000,P<0.05).The multivariate regression model showed that the shorter the time from infection to onset,the higher the severity of the disease(OR=1.141,P=0.007);the more standard antiviral treatment within 2 weeks before the onset of disease was used,the less severe the disease was.(OR=0.991,P<0.001);the lower the minimum lymphocyte count in the course of the disease,the more serious the disease was(OR=0.062,P<0.001);the more standard antiviral drugs were used within 2 weeks before the onset of the disease,the milder the disease was(OR=0.062,P<0.001)The higher the CRP level was,the more serious the condition was(OR=0.266,P<0.001);the more positive times of nucleic acid detection in the course of disease,the more serious the disease was,and the difference was statistically significant(OR=1.135,P=0.005).Conclusion Novel coronavirus pneumonia patients in the course of disease development,the time of infection to the onset of illness,the 2 weeks before the onset of the disease,whether the standardized use of antiviral drugs and treatment types,the lowest lymphocyte count,the highest CRP in the course of disease,and the number of positive nucleic acid tests in the course of disease are the most influential factors,and can be judged as the influencing factors.