老年慢性肾脏病3~5期非透析患者心脏瓣膜钙化特点及其与血清骨代谢标志物的相关性

目的 探讨并分析南通地区新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)聚集性患者的临床特点。 方法 采用回顾性单中心研究方法,收集2020年1月27日至2月17日南通市第三人民医院隔离病房收治的15例COVID-19聚集性患者的一般资料,按照聚集性疫情调查分析,分为五组,分别对其流行病学特征、临床表现、实验室检查和影像学特点进行分析。结果 15例患者中,男7例,女8例。年龄范围为27～67岁,五组患者平均年龄为(47.33±14.38)、(51.50±5.50)、(65.00±1.00)、(52.00±1.79)、(57.33±12.28)岁。潜伏期平均为(3.00±1.41)、(5.50±0.50)、(5.00±0.00)、(9.20±4.26)、(8.67±4.11)d。轻型患者1例(6.7%),普通型13例(86.7%),重型1例(6.7%)。五组患者中临床表现以发热为主的患者13例(86.7%),乏力14例(93.3%),咳嗽9例(58.7%),呼吸困难6例(40%),无头痛咽喉痛及消化道症状病例,基础疾病以高血压为主,并发症以肝损害为主,1例(6.7%)无任何临床表现。五组患者均有不同程度淋巴细胞计数,CD4+T淋巴细胞计数,CD8+T淋巴细胞计数及B淋巴细胞计数下降,其中三组平均淋巴细胞计数下降明显。感染指标如CRP、ESR、铁蛋白普遍升高,PCT均表现为正常。肝功能除AST轻度升高外,余均正常。乳酸水平均高。氧合指数有一组(20%)患者明显降低。影像学改变主要为双侧病变,无胸腔积液。结论 南通市新型冠状病毒肺炎聚集性病例以家庭聚集性病例为主,倾向于中老年人,常与慢性病高血压共存,肝损害为主要并发症,基本为普通型。临床表现主要为发热、乏力、咳嗽。实验室检查血乳酸水平均高,T淋巴细胞计数下降明显,余无特异性改变。

Cardiac valve calcification and its relationship with serum bone turnover markers in elderly patients with stage 3-5 non-dialysis chronic kidney disease

Objective To investigate and analyze the clinical characteristics of patients with clustering of novel coronavirus disease (COVID-19) in Nantong. Methods The retrospective single-center research method was used to collect the general data of 15 cases of COVID-19 clustering patients admitted to the isolation ward of Nantong Third People"s Hospital from January 27 to February 17, 2020. According to the cluster epidemic investigation and analysis, we divided patients into five groups, and analyzed their epidemiological characteristics, clinical manifestations, laboratory and imaging characteristics. Results The patients included 7 males and 8 females. The age range was 27 to 67 years old. The average age of the patients in the five groups was (47.33 ± 14.38), (51.50 ± 5.50), (65.00 ± 1.00), (52.00 ± 1.79), and (57.33 ± 12.28) years. The average incubation period was (3.00 ± 1.41), (5.50 ± 0.50), (5.00 ± 0.00), (9.20 ± 4.26), (8.67 ± 4.11) d.Including 1 mild patient (6.7%), 13 normal (86.7%) patients, and 1 severe(6.7%) patient.Including 1 mild patient (6.7%), 13 normal (86.7%) patients, and 1 severe(6.7%) patient. common symptoms included fever(13 cases,86.7%) ,fatigue(14 cases, 93.3%) , cough(9 cases, 58.7%) , dyspnea (6cases, 40%) , and headache, sore throat and digestion were not presen. The underlying disease was mainly hypertension, and the complications were mainly liver damage. One case (6.7%) didn"t have any clinical manifestations. The five groups of patients had varying degrees of lymphocyte counts. The CD4 + T lymphocyte counts, CD8 + T lymphocyte counts, and B lymphocyte counts were decreased and the average lymphocyte counts of three groups decreased significantly. Infection indicators such as CRP, ESR, and ferritin were generally elevated, and PCT was normal. Except for a slight increase in AST, liver function was normal. The lactic acid level is high. The oxygenation index decreased significantly in one group (20%). The imaging changes were mainly bilateral lesions without pleural effusion. Conclusion The cases of novel coronavirus pneumonia in Nantong are mainly clustered in families. They tend to be middle-aged and elderly, and often coexist with chronic diseases and hypertension. Liver damage is the main complication, which is basically common. The clinical manifestations were fever, fatigue, and cough. Laboratory tests showed that blood lactate levels were high, T-lymphocyte counts were significantly reduced, and no specific changes remained.