200例新冠肺炎住院患者转归影响因素分析

目的探索武汉市某三甲综合医院早期收治的新冠肺炎患者死亡的可能影响因素。方法收集该医院2020年2月1日起截至2月29日治愈出院和死亡的确诊新冠肺炎患者的基本信息和临床资料,排除相关数据缺失者,采用二元Logistic回归分析死亡患者的危险因素。结果 200例新冠肺炎住院患者中,非参数检验发现治愈出院患者和死亡患者两组中有统计学差异的因素包括性别、年龄、是否病危、是否病重、伴有心血管基础疾病、伴有糖脂代谢异常基础疾病、伴有肾脏疾病、伴有脑血管疾病,住院期间包括白细胞计数、淋巴细胞计数、淋巴细胞百分比、乳酸脱氢酶、磷酸肌酸激酶、肌红蛋白、肌钙蛋白T、C反应蛋白、D-二聚体和白介素-6这些关键实验室指标的数值,回归分析得出性别、年龄、病危、伴有心血管基础疾病、伴有糖脂代谢异常基础疾病、伴有肾脏系统基础疾病以及住院期间淋巴细胞计数、肌钙蛋白T、D-二聚体和白介素-6等因素对患者转归有影响。结论影响新冠肺炎住院患者转归的影响因素较多,其中女性和住院期间淋巴细胞计数是保护性因素,伴有基础疾病、住院期间肌钙蛋白T、D-二聚体和白介素-6异常增高是危险因素,临床医护工作人员需要密切关注D-二聚体和白介素-6指标,及时采取相应救治措施避免或减轻"炎症风暴"对新冠肺炎患者转归有重要意义。

Exploratory Analysis on Outcome Influencing Factors of 200 Patients with COVID-19

Objective To explore the possible influencing factors of death in patients with the 2019 novel coronavirus pneumonia treated early in a tertiary general hospital in Wuhan.Methods The basic information and clinical data of patients diagnosed with the 2019 new coronavirus pneumonia that were cured and discharged from February 1 to February 29 were collected,and those who lacked relevant data were excluded.The risk factors of death patients were analyzed by binary logistic regression.Results Among 200 inpatients with the 2019 novel coronavirus pneumonia,statistical difference(P value<0.05)were found in the two groups of patients who were discharged from the hospital and those who died,including gender,age,critical illness,severe illness,accompanied with cardiovascular disease,accompanied with abnormal glucose and lipid metabolism,accompanied with kidney disease,and the values of key laboratory indicators during hospitalization,such as white blood cell count,lymphocyte count,lymphocyte percentage,lactate dehydrogenase,phosphocreatine kinase,myoglobin,troponin T,and C-reactive protein,D-dimer and interleukin 6.Regression analysis revealed the gender,age,critical illness,accompanied with cardiovascular disease,accompanied with abnormal glucose and lipid metabolism,accompanied with renal disease,the values of the lymphocyte count,troponin T,D-dimer,and interleukin-6 during the period of hospitalization had an effect on patient outcomes.Conclusion There are many factors influencing the outcome of hospitalized patients with 2019 novel coronavirus pneumonia.Among them,the value of lymphocyte counts and the female are protective factors,while accompanied with basic diseases,abnormal increases of troponin T,D-dimer and interleukin-6 during hospitalization are the risk factors.Clinical medical staffs need to pay close attention to the D-dimer and interleukin-6 indicators,and it is of great significance to take corresponding rescue measures in time to avoid or reduce the“inflammatory storm”for the outcome of patients with the 2019 novel coronavirus pneumonia.