普通型与重型新型冠状病毒肺炎患者临床分析

目的 分析严重急性呼吸综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）感染引起新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）患者普通型与重型的流行病学、实验室检查及影像学特征,为COVID-19防治提供经验依据。 方法 选取2020年1—2月在池州市人民医院、皖南医学院第一附属医院隔离病房收治的23例COVID-19患者为研究对象。将患者分为普通型（19例）、重型（4例）两组,根据两组流行病学、血生化、血常规等实验室数据,比较和分析两组患者血清中上述各指标变化的规律及其与疾病预后的关系。 结果 COVID-19患者普通型与重型无性别与年龄差异,2例重型患者合并有基础疾病,为2型糖尿病;重型患者发病至就诊的平均时间为（10.00±6.67）d,长于普通型（3.73±2.97）d（P<0.05）;实验室结果显示重型患者的淋巴细胞比值为（10.20±7.19）%,低于普通型患者淋巴细胞比值为（28.06±9.47）%（P<0.05）;两组的CRP结果,普通型为(16.46±19.24)mg/L,重型为(73.65±44.96)mg/L（P<0.05）;COVID-19患者典型的CT表现为单发或多发的斑片状磨玻璃影,伴有小叶间隔增厚。疾病进展为重型时病灶增多、范围扩大,磨玻璃影与实变影或条索影共存,部分重症患者表现为双肺弥漫性病变。 结论 对于新型冠状病毒肺炎患者如果合并有基础病,就诊时间长;实验室检查示淋巴细胞绝对值下降,CRP升高等,建议短期复查HRCT,防止普通型向重型发展。

Clinical analysis of common and severe COVID-19 patients

Objective To analyze the epidemiology, laboratory examination and imaging of common and severe type of coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2）. Methods In this study, 23 patients with COVID-19 admitted to the isolation ward of Chizhou People's Hospital and the First Affiliated Hospital of Wannan Medical College from January to February 2020 were selected to analyze the characteristics. According to the relevant diagnostic criteria, the patients were divided into two groups: common type (19 cases) and severe type (4 cases). Combined with the epidemiology and laboratory data, such as blood biochemistry, blood routine, in the two groups, the changes of the above indexes in the serum of patients were compared and analyzed to predict the prognosis. Results There were no differences in gender and age between severe patients and common patients of COVID-19. There were 2 patients with type 2 diabetes. The average time from onset to treatment for severe patients was (10.0±6.67) days, which was longer than common patients’ (3.73±2.97) days (P<0.05); Laboratory tests showed that the lymphocyte ratio of severe patients was (10.20±7.19)%, which was significantly lower than that of common patients (28.06±9.47)% (P <0.05); the results of CRP in two groups were (16.46±19.24) mg/L for the common type and (73.65±44.96) mg/L for the severe type (P<0.05); The CT manifestations of typical cases were single or multiple patchy ground glass shadow with thickening of interlobular septum; the lesions increased and expanded when the disease progressed, ground glass shadow coexisted with solid change shadow or strip shadow, and some severe patients showed diffuse lesions of both lungs. Conclusion For COVID-19, if they have a basic disease and have been sick for a long time; laboratory tests show that the absolute value of lymphocytes decreased, and CRP increased. It is recommended to review HRCT immediately to prevent the common type developing to be severe.