不同奥密克戎变异株感染患者的凝血和心肌标志物比较

Comparison of coagulation and myocardial markers in patients infected with different Omicron variants

目的回顾分析2022年上海地区春季和冬季不同奥密克戎变异株感染患者的凝血指标和心肌标志物结果。方法收集2022年4月18日—5月15日(春季株组,BA.2变异株)以及2022年12月14日—2023年1月31日(冬季株组,BA.5和BF.7变异株)新冠病毒感染者共1388例,其中春季株组974例,冬季株组414例,比较两组患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D二聚体(DD)、纤维蛋白原降解产物(FDP)和抗凝血酶Ⅲ(ATⅢ)活性、高敏肌钙蛋白I(hsTnI)、肌红蛋白(MYO)、心肌激酶同工酶MB(CK-MB)、高敏肌钙蛋白T(hsTnT)和B型利钠肽(BNP)的结果。结果与春季株感染患者相比,冬季株感染者的DD、FDP、hsTnI、MYO、hsTnT和CK-MB水平明显升高,ATⅢ活性明显下降,差异具有统计学意义(P<0.01)。而APTT结果基本一致,差异无统计学意义(P>0.05)。结论不同奥密克戎变异株感染者的临床表现不尽相同,及时关注实验室检验结果,可为临床患者的诊断和治疗提供实验室依据。

Objective To retrospectively analyze the coagulation and myocardial markers of patients infected with different Omicron variants in spring and winter in Shanghai during 2022.Method A total of 1388 patients infected with severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)from April 18,2022 to May 15,2022(spring strain group,BA.2 variant)and from December 14,2022 to January 31,2023(winter strain group,BA.5 and BF.7 variants)were collected.Prothrombin time(PT),activated partial thromboplastin time(APTT),DD dimer(DD),fibrinogen degradation products(FDP),antithrombinⅢ(ATⅢ),high sensitivity troponin I(hsTnI),myoglobin(MYO),cardiac kinase isoenzyme MB(CK-MB)and hsTnT were measured in 1388 patients(974 cases in spring strain group and 414 cases in winter strain group).Results The levels of DD,FDP,hsTnI,MYO hsTnT and CK-MB were significantly higher and the activity of ATⅢwas significantly lower in patients infected with winter strain than those infected with spring strain(P<0.01).While APTT was not statistically significant(P>0.05).Conclusion The clinical characteristics of patients infected with different Omicron variants are different.Paying attention to the laboratory markers in time can provide laboratory basis for the diagnosis and treatment of COVID-19.