1例危重症新型冠状病毒肺炎的感染相关指标分析

Analysis of infection related indicators of a critical case with novel coronavirus pneumonia

目的探讨感染相关指标在危重症新型冠状病毒肺炎(COVID-19)患者诊疗过程中的动态变化及临床价值。方法回顾性分析该院收治的1例危重症COVID-19患者的临床资料,监测感染相关指标的动态变化特点。结果该患者具有典型流行病学史,以反复发热就诊,并迅速进展至胸闷气紧和呼吸困难,新型冠状病毒(2019-nCoV)核酸检测阳性,诊断为COVID-19危重型。在疾病进展期,感染相关指标中性粒细胞比例(NEU%)迅速上升,淋巴细胞百分比(LYM%)持续下降,T淋巴细胞亚群进行性降低,NLR及N8R值随病情轻重呈相应增高趋势,而白细胞介素-6(IL-6)与NLR值变化基本一致,超敏C-反应蛋白(hs-CRP)与N8R值变化基本一致。经对症支持治疗后,患者症状缓解,病毒核酸检测转阴,上述感染指标均逐渐恢复正常。结论实时监测病程期间中NEU及LYM、淋巴细胞亚群、NLR及N8R值、IL-6及hs-CRP水平,将有助于COVID-19患者的病情进展判断及预后评估。

Objective To explore the dynamic changes and clinical value of infection-related indicators in the diagnosis and treatment of a critical patient with COVID-19.Methods Analyzed the clinical data of a critical patient with COVID-19 in Mianyang 404 hospital retrospectively,and monitored the dynamic change trend of infection-related indicators.Results The results showed that this critical patient had a typical epidemiological history and was admitted to hospital with repeated fever,then rapidly progressed to chest tightness and dyspnea.Subsequently,2019-nCoV nucleic acid test positive,which was confirmed as COVID-19.During the stage of disease progression,infection-related indicators NEU%increased rapidly,LYM%continued to decline.And T lymphocytes subsets decreased progressively,NLR and N8R values increased with the severity of the disease.In addition,the changes of IL-6 and NLR values were basically consistent,and the changes of hs-CRP and N8R values were basically consistent.Subsequently,after symptomatic support treatment,the patient′s symptoms got better,and the viral nucleic acid detection turned negative,and the above infection indicators gradually returned to normal.Conclusion It is suggested that real-time detection of infection-related indicators NEU and LYM,T lymphocytes subsets,NLR and N8R,IL-6 and hs-CRP values will be helpful for the monitoring of disease progression and prognosis evaluation.