凝血功能异常对新冠肺炎重症患者的预后意义

目的分析新型冠状病毒肺炎(corona virus disease 2019, COVID-19)患者凝血功能的临床特征，及其对重症化的预测和预后意义。 方法收集2020年2月至4月在武汉泰康同济医院确诊的COVID-19患者356例的凝血功能指标，分析其与COVID-19重症化、预后的关联。 结果356例患者入院时，普通型200例，重型118例，危重38型例。出院时，普通型190例，重型107例，危重型59例。患者凝血酶原时间(prothrombin time, PT)越长、D二聚体越高(D-dimer, DD)D-二聚体越高(D-dimer, D-dimer)、血小板计数越低，诊断为重型和危重型的概率越高(P<0.05)。年龄显著影响重症化(P<0.05，OR＝1.054)，年龄每增加1，重症化概率提升0.054倍。PT能显著影响重症化(P<0.05，OR＝1.245)，PT每提升1，重症化概率提升0.245倍。 结论高龄、心血管系统基础疾病、PT延长、D二聚体升高，是COVID-19患者重症化的高危因素和预测、预后重要因素。

Prognostic significance of abnormal coagulation function in critically ill patients of COVID-19

ObjectiveTo analyze the clinical characteristics of blood coagulation function in patients with COVID-19 and its significance in predicting and prognosis of severe symptoms. MethodThe coagulation function data of COVID-19 patients diagnosed in Wuhan Taikang Tongji Hospital from February to April 2020 were collected and their correlation with the severity and prognosis of COVID-19 patients. ResultsA total of 356 patients who met the criteria were collected. at the time of admission, there were 200 cases of common type, 118 cases of severe type and 38 cases of critical type. At discharge, there were 190 cases of common type, 107 cases of severe type and 59 cases of critical type. The critically ill patients with significantly elevated D-dimer and heparin intervention were defined as heparin group, and the critically ill patients with significantly elevated D-dimer without heparin intervention were defined as non-heparin group. There were 53 cases in heparin group and 41 cases in non-heparin group. The longer the prothrombin time (PT), the higher the D-dimer (DD), the higher the D-dimer (D-dimer) and the lower the platelet count, the higher the probability of diagnosis of severe and critical patients. Age could significantly affect the severity of symptoms (P<0.05, OR=1.054), every 1 increase in age increases the probability of severe illness by 0.054 times. PT can significantly affect the severity of symptoms (P<0.05, OR=1.245), for every 1 increase in PT, the probability of severe illness increases by 0.245 times. ConclusionCOVID-19 patients with advanced age, basic cardiovascular diseases, prolonged PT and elevated D-dimer are all high risk factors for severe illness and important factors for predicting the prognosis of critically ill patients.