83例新型冠状病毒感染患者病例特点及中西医综合治疗分析

Clinical Characteristics and Comprehensive Treatment of Traditional Chinese and Western Medicine in 83 Patients with Corona Virus Disease 2019

目的分析大连市第三轮疫情83例新型冠状病毒(简称新冠病毒)感染患者临床特点。方法83例新冠病毒感染患者分为新型冠状病毒肺炎(corona virus disease 2019,COVID-19)组(n=51例)及无症状感染组(n=32例),对患者流行病特点、症状、基础病、入院生命体征、血常规、肝肾功能、新冠病毒抗体等行回顾性分析,并总结所有新冠病毒感染者核酸检测、胸部CT结果及中西医综合治疗方案。在51例COVID-19组病人中,除1例重型孕妇、5例儿童及2例婴幼儿未采用中医治疗外,其他都采用了中药治疗。结果COVID-19组不典型表现或无明显症状者较多见,肺炎组患者年龄更大,嗜酸性粒细胞及百分比、白蛋白水平更低,C反应蛋白、D-二聚体、纤维蛋白原、乳酸脱氢酶及r-谷氨酰转肽酶更高,有统计学差异。COVID-19组患者免疫球蛋白M及G抗体升高更早、抗体峰值更高。COVID-19组胸部影像学更多表现为双肺均受累,两组治疗侧重点不同。结论COVID-19常症状隐匿,影像学表现以双肺受累多见,与无症状者相比,多种血细胞及生化指标有明显差异,一般患者实施以中医调理为主的治疗及一些有基础病的老年重症患者实施个体化综合治疗均获得良好效果,其中一例重症接近预产期(36周孕1产1)的孕妇及时行剖腹产术后,新生儿未感染新冠病毒,可使母婴平安。

Objective The aim of this study was to analyze the characteristics of 83 cases of corona virus disease 2019(COVID-19)in Dalian.Methods 83 cases of novel coronavirus infection were divided into COVID-19 group(n=51)and Asymptomatic infection Group(n=32).The epidemiological characteristics,symptoms,basic diseases,vital signs,hemocyte examination,liver and kidney function,and novel coronavirus antibody were analyzed retrospectively.We summarized the nucleic acid detection,chest CT results and drug prescription of all patients with novel coronavirus infection.In 51 cases of COVID-19,43 cases were treated with traditional Chinese medicine.Results Atypical manifestations or no obvious symptoms were common in patients with COVID-19.Patients in the COVID-19 group were older,had lower eosinophil granulocyte and percentage,lower levels of serum albumin,while higher C reactive protein,D-dimer,fibrinogen,lactate dehydrogenase andγ-glutamyl transpeptadase.The increase of Immunoglobulin M and Immunoglobulin G antibody was earlier,and the peak value were higher in the COVID-19 group.Double lungs were usually involved in COVID-19 group.The prognosis of 83 patients was favourable.Conclusions The clinical presentation of COVID-19 could be very atypical,and was usually manifested by double lung involvement.There were significant differences in blood cells and biochemical indexes between the patients with COVID-19 and asymptomatic infection,the treatment of general patients mainly based on traditional Chinese medicine and the individualized comprehensive treatment of some elderly severe patients with basic diseases have achieved good results.Among them,one severe case is close to the expected date of delivery(one birth at 36 weeks’gestation).After the timely caesarean section,the newborns are not infected with SARS-CoV-2,which can make the mother and baby safe.