新冠肺炎(COVID-19)临床信息及胸部CT影像表现的初步探讨及文献复习

Preliminary Discussion and Literature Review for Clinical Information and Chest CT Imaging Findings in the Patients with Coronavirus Disease 2019 Pneumonia

目的 分析与探讨新冠肺炎患者的临床信息与胸部CT影像表现以提高其诊断水平。方法 回顾性收集我院2020年1月16日至2020年2月22日的14例COVID-19肺炎患者的临床生化检查及胸部CT影像数据并分析,包括是否存在暴露史、临床表现、实验室检查、核酸检测及胸部CT检查。结果 14例患者的平均年龄为46.5岁。7例患者出现发热(50.00%),7例患者出现咳嗽(50.00%),是最常见的临床症状。累及4叶以上的病例有8例(57.14%),病变分布累及右肺下叶9例(64.29%)。胸部影像表现主要有磨玻璃密度灶(64.29%)、支气管血管束增粗(64.29%)、纤维灶(50.00%)、实变灶(57.14%),大部分患者无胸腔积液(85.71%),全部患者无纵隔内淋巴结增大(100.00%)。胸部CT检查结果阳性(10例)与胸部CT检查阴性(4例)的生化检查,仅纤维蛋白原在两者间差异具有显著统计学意义(P<0.05)。结论 新冠肺炎的胸部CT影像表现具有一定的特征性,但是诊断COVID-19需要结合临床信息进行综合分析,以提高诊断效能及准确率。

Objective to analyze and discuss the clinical information and chest CT imaging performance of patients with ncoronavirus disease 2019 pneumonia, and to improve the diagnosis performance. Methods To retrospectively collect and analyze the clinical biochemical test and chest CT imaging data of 14 cases with COVID-19 pneumonia in our hospital from January 16, 2020 to February 22, 2020, including whether there is a history of exposure, clinical manifestations, and laboratory tests, nucleic acid detection and chest CT examination. Results The average age of the 14 cases was 46.5 years. Fever(50.00%) occurred in 7 cases, and cough(50.00%) occurred in 7 cases, which was the most common clinical symptom. There were 8 cases(57.14%) involving more than 4 lobes, and 9 cases(64.29%) involving the lower lobe of the right lung. Chest imaging features mainly include ground-glass opacities(64.29%), bronchial vascular bundle thickening(64.29%), fibrous(50.00%), consolidation(57.14%). Most of cases have no pleural effusion(85.71%) and no lymph nodes in the mediastinum were enlarged(100.00%). Fibrinogen was significant difference observed between positive chest CT examination results(n=10) and negative chest CT examination(n=4). Conclusion The chest CT image of coronavirus disease 2019 pneumonia has certain characteristics, but the diagnosis of COVID-19 requires a comprehensive analysis combined with clinical information.