54例新型冠状病毒肺炎患者的临床特征及激素疗法的效果分析

Clinical Characteristics and Therapeutic Efficacy of Glucocorticoids in 54 Patients with COVID-19

目的:分析54例新型冠状病毒肺炎(COVID-19)患者的临床特征与糖皮质激素的疗效。方法:采用回顾性研究的方法,收集2020年1月25日-2月20日苏州市第五人民医院收治的确诊为COVID-19的54例患者,分为激素治疗组(21例)和常规组(34例),分析2组患者的临床特征,以及使用糖皮质激素后的疗效。结果:2组患者的年龄、性别、症状出现到住院时间、谷丙转氨酶(glutamic-pyruvic transaminase,GPT)、肌酐(creatinine,Cr)和C反应蛋白(C reactive protein,CRP)值等经比较其差异无统计学意义(P>0.05),但是激素治疗组患者入院时氧合指数(oxygenation index,OI)明显低于常规组(P<0.05),发生急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者比例高于常规组(P<0.05),激素组患者的淋巴细胞(lymphocyte,LYM)计数低于常规组(P<0.05),白细胞(white blood cell,WBC)计数高于常规组(P<0.05);2组患者的咽拭子转阴时间经比较其差异无统计学意义(P>0.05),2组患者的中位数转阴时间均为12 d(W=303.5,P=0.4498),而CT出现吸收的中位数时间为8 d(W=391,P=0.4316)。结论:WBC和LYM计数、OI值与新型冠状病毒肺炎的严重程度相关,而使用糖皮质激素未影响患者的核酸转阴及影像学吸收效果。

Objective: To analyze the Clinical characteristics and therapeutic efficacy of glucocorticoids in 54 patients with COVID-19. Methods: A retrospective study was conducted to collect 54 patients diagnosed with COVID-19 admitted to The FifthPeople’s Hospital of Suzhou from January 25 to February 20, 2020, who were divided into glucocorticoid treatment group(21 cases) and routine treatment group(34 cases), and the clinical characteristics and the effects of glucocorticoids of the two groups were analyzed. Results: There was no statistical significance of age,sex, symptom onset to hospital stay, glutamic-pyruvic transaminase(GPT), creatinine(Cr) and C reactive protein(CRP)in 2 groups(P>0.05). However, the oxygenation index(OI) in the hormone treatment group was significantly lower than that in the conventional group(P<0.05), and the proportion of patients with acute respiratory distress syndrome(ARDS) was higher than that in the conventional group(P<0.05). The lymphocyte(LYM) count in hormone group was lower than that in conventional group(P<0.05), while the white blood cell count was higher than that in conventional group(P<0.05). There was no significant difference in the time of negative swab conversion between the two groups(P>0.05), and the median time of negative swab conversion between the two groups was 12 days(W=303.5, P=0.4498), while the median time of absorption on CT was 8 days(W=391, P=0.4316). Conclusions: WBC and LYM counts and OI values are correlated with the severity of COVID-19, while glucocorticoids do not affect the negative nucleic acid conversion and imaging absorption effect of patients.