新型冠状病毒肺炎患者免疫应答规律分析

目的分析新型冠状病毒肺炎患者免疫应答规律。方法回顾性分析2022年12月至2023年1月COVID-19确诊患者183例。根据病情分为普通型、重型、危重型和死亡四组。根据病程分为早期、中期、后期。结果183例患者,男85例,女98例;年龄(55.64±14.67)岁。普通型129例(70.5%),重型29例(15.8%),危重型15例(8.2%),死亡10例(5.5%)。早期(6.18±2.90)d,中期(11.87±3.73)d,后期(18.88±5.57)d。随着病情加重,淋巴细胞计数(LY)呈下降趋势(P<0.05);中性粒细胞计数(NE)和C反应蛋白(CRP)呈上升趋势(P<0.05)。随着病程演变,普通型LY和NE呈上升趋势(P<0.05);CRP中期最高(P<0.05)。死亡组起病开始至结束LY明显低下;NE和CRP持续上升(P<0.05)。重型组和危重症组LY早期降至最低(P<0.05);NE和CRP中期最高(P<0.05)。结论COVID-19患者持续LY下降,是疾病进展的表现;NE和CRP持续上升,清除病毒同时,也有可能存在免疫紊乱和过度炎症反应,临床需要加强动态监测。

Objective To analyze the immune response patterns of patients with novel coronavirus pneumonia.Methods A retrospective analysis included 183 patients diagnosed with COVID-19 from December,2022 to January,2023.According to the condition,it was divided into general,severe,critical and death groups.The basic course of disease was divided into early,middle and late stages.Results There were 183 cases of COVID-19,85 cases for men,98 cases for women,and the average age was 55.64±14.67 years old.And 129 cases were ordinary type(70.5%),29 cases were severe(15.8%),15 cases were critical cases(8.2%)and 10 cases were deaths(5.5%).Acute period was(6.18±2.90)d,subacute period was(11.87±3.73)d,chronic stage was(18.88±5.57)d.As the condition worsen,lymphocyte count(LY)showed a downward trend(P<0.05);neutrophil count(NE)and C-reactive protein(CRP)showed an upward trend(P<0.05).As the course of the disease evolved,the ordinary LY and NE showed an upward trend(P<0.05);the middle stage of CRP was the highest(P<0.05).LY fell significantly from the beginning to the end of the death group;NE and CRP continued to rise(P<0.05).The early stage of LY in the severe and critical groups was minimized(P<0.05);the middle stage of NE and CRP was the highest(P<0.05).Conclusion The continuous decline of LY in patients with COVID-19 is a reflection of the progress of the disease;NE and CRP continue to rise.While removing the virus,there may also be immune disorders and excessive inflammatory reactions.Clinically,dynamic monitoring needs to be strengthened.