不同年龄段新型冠状病毒肺炎患者胸部CT特征比较

目的:分析比较不同年龄段新型冠状病毒肺炎患者胸部CT图像及临床资料,提高对新型冠状病毒肺炎影像学特征认识。方法:回顾性分析2020年1月16日-2月12日确诊49例新型冠状病毒肺炎患者胸部CT图像和临床资料,将患者按年龄分为45岁以下(n=26)和45岁以上(n=23)两组,比较两组患者临床特征、实验室检查和胸部CT表现差异。结果:患者常见胸部CT表现包括磨玻璃影和实变影。45岁以上和45岁以下患者出现磨玻璃影构成比无统计学差异(P>0.05)。45岁以上患者出现实变影和小叶间隔增厚构成比高于45岁以下患者(19/23 vs 14/26、16/23 vs 9/26,P<0.05)。患者平均累及肺叶数为(3.31±1.70)个,45岁以上多于45岁以下患者(3.96±1.33 vs 2.73±1.80,t=-2.729,P<0.01)。45岁以上合并基础疾病患者占比高于45岁以下合并基础疾病者(11/26,P<0.001)。所有患者中白细胞计数正常或下降45例,淋巴细胞计数下降10例,血清C反应蛋白升高者28例,45岁以上C反应蛋白升高患者为17/23,高于45岁以下患者(P<0.05)。结论:新型冠状病毒肺炎患者影像学表现多样,不同年龄段的影像表现和临床特点也不同。45岁以上患者更常出现实变影和小叶间隔增厚,肺部病变累及范围更大,且合并基础疾病患者占比更多。

Chest CT findings of coronavirus disease 2019 in different ages

Objective:Chest CT and clinical characteristics of novel coronavirus pneumonia(NCP)in different ages were evaluated,and further to improve the recognition of the disease.Methods:From January 16 to February 12,2020,CT and clinical data of 49 cases with COVID-19 were retrospectively analyzed,patients were divided into two groups according to their ages:under 45 years old(n=26)and over 45 years old(n=23).The clinical characteristics,laboratory and CT findings between the two groups were compared.Results:Ground glass opacity(39/49)and consolidation(33/49)were the most common CT features.There was no significant difference in ground glass opacity between the two groups.The incidences of consolidation and interlobular septal thickening in over 45 years were significantly higher than that in under 45 years(19/23 vs 14/26、16/23 vs 9/26,respectively,both P<0.05).There were more lobes involved in patients over 45 years old compared with patients under 45 years old(3.96±1.33 vs 2.73±1.80,t=-2.729,P<0.01).The patients over 45 years old with underlying diseases(11/23)were more than that patients under 45 years old(2/26,P<0.001).Most patients had normal or decreased white blood cell count(45/49),10 patients with reduced lymphocyte count,and 28 patients with elevated serum C-reactive protein(CRP).The proportion of patients over 45 years old with elevated CRP was 17/23,which was higher than that under 45 years old(11/26,P<0.05).Conclusions:The CT findings and clinical manifestations of COVID-19 in different ages groups are distinct.Patients over 45 years old are more likely to have consolidation and interlobular septal thickening,with more lung lesions involved and more underlying comorbidities.