烟台市与威海市新型冠状病毒肺炎病例临床与实验室特征分析

Clinical and laboratory characteristics of COVID-19 cases in Yantai and Weihai

目的回顾性分析新型冠状病毒肺炎(Coronavirus Disease 2019,COVID-19)患者的临床及实验室特征,为临床诊治提供参考依据。方法收集2020年1月23日至2020年2月13日烟台市奇山医院收治的72例确诊COVID-19患者的基本信息、临床症状、实验室指标、胸部CT表现等临床资料。根据疾病严重程度,分为非重症组和重症组,比较两组的实验室检查特征。采用SPSS 22.0软件进行统计分析。结果72例患者中,男性40例、女性32例,平均年龄(46.0±14.8)岁。症状主要表现为发热(84.7%)、咳嗽(77.8%),其中咳痰45例(62.5%),均为少量白色粘痰。淋巴细胞计数减少26例(36.1%),T淋巴细胞绝对数下降18例(25.0%),CD4+T细胞计数下降8例(11.1%),CD8+T细胞计数下降14例(19.4%),ESR升高42例(58.3%),CRP升高31例(43.1%)。重症组患者外周血淋巴细胞(L)、白蛋白、CD4+T细胞、CD8+T细胞、T淋巴细胞绝对数低于非重症组,CRP、SAA、ESR、FIB、AST、肌酸激酶、乳酸脱氢酶高于非重症组(P<0.05)。72例患者核酸检测鼻咽拭子、痰液标本连续两次转阴时间分别为(21.48±7.9)d和(27.79±7.4)d,两种检测方法连续2次转阴时间存在统计学差异(t=-4.532,P=0.000)。COVID-19患者胸部CT主要表现为双肺病变58例、斑片状51例、磨玻璃影61例。结论烟台市与威海市COVID-19患者临床分型以普通型为主,T淋巴细胞亚群等实验室指标异常可能预示着患者病情更重。

Objective To analyze the clinical and laboratory features of patients with Coronavirus Disease 2019(COVID-19),for providing reference for the diagnosis and treatment of the disease.Methods The clinical data of 72 patients confirmed as COVID-19 in Qishan hospital during January 23,2020 to February 13,2020 were collected.The data included the general information,clinical manifestations,laboratory tests and CT findings of the lungs.According to the severity of the disease,the patients were divided into the non-severe group and the severe group,and the laboratory tests characteristics of the two groups were compared.SPSS 22.0 statistical software was used for data analysis.Results In the 72 patients,40 were males and 32 females,the average age was(46.0±14.8)years.The main clinical manifestations were fever(84.7%)and cough(77.8%).Among them,45 cases(62.5%)had expectoration with a small amount of white sticky sputum.The main laboratory results showed that lymphocyte count decreased in 26 cases(36.1%),the absolute number of T lymphocytes decreased in 18 cases(25.0%),CD4+T cell count decreased in 8 cases(11.1%),CD8+T cell count decreased in 14 cases(19.4%),ESR increased in 42 cases(58.3%),and CRP increased in 31 cases(43.1%).Peripheral blood lymphocyte(L),albumin,CD4+T cell,CD8+T cell,T-lymphocyte in severe group(n=61)were lower than those in non-severe group(n=11),while C-reactive protein(CRP),serum amyloid A(SAA),erythrocyte sedimentation rate(ESR),fibrin(FIB),aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydrogenase(LDH)in severe group were higher than those in non-severe group(P<0.05).In 72 patients,the negative time of the twice nucleic acid detection from nasopharyngeal swabs and sputum specimens were(21.48±7.9)days and(27.79±7.4)days,there were significant differences between the two groups of specimens for two consecutive negative times(t=-4.532,P=0.000).The main pulmonary imaging manifestations of COVID-19 patients:two lungs in 58 cases,patchy opacities in 51 cases and ground glass shadows in 61 cases.Conclusions Most of the COVID-19 patients in Yantai and Weihai were common type.The abnormal T lymphocyte,subcohorte and other laboratory indicators may indicate that the patients are more serious.