新型冠状病毒肺炎检验指标在病情评估中的应用

目的观察新型冠状病毒肺炎（COVID-19）病人检验指标与病情轻重的关系，旨在早期识别重症病人。方法收集86例COVID-19病人资料，按病情严重程度分为非重症组（n=68）和重症组（n=18）。分析2组的实验室检查，采用SPSS 18.0系统进行统计分析。结果非重症和重症组病人性别、年龄及武汉旅居史差异均无统计学意义（P>0.05），重症病人血常规中淋巴细胞计数及百分比、T细胞亚群中总T淋巴细胞、CD4+淋巴细胞、CD8+淋巴细胞均低于非重症肺炎病人，而乳酸脱氢酶（LDH）、C反应蛋白、血清淀粉样蛋白A、白细胞介素-6重症组均高于非重症组（P < 0.01）；logistic回归分析显示LDH升高是新型冠状病毒肺炎病人加重的危险因素，CD4+淋巴细胞降低是保护性因素。结论COVID-19病人的多项实验室指标均有明显变化，对于病情轻重的评估有参考价值，尤其LDH的升高和CD4+淋巴细胞的减少在重症病人中的表现明显。

Application value of COVID-19 test indexes in assessing the disease severity

ObjectiveTo observe the relationship between the test indexes of patients with corona virus disease 2019(COVID-19) and disease severity, and identify the critical patients early.MethodsThe data of 86 patients with COVID-19 were collected.The patients were divided into the non-severe group(n=68) and severe group(n=18) according to the severity of illness.The results of laboratory test in two groups were analyzed using SPSS 18.0.software.ResultsThe differences of the gender, age, and history of residence in Wuhan between two groups were not statistically significant(P>0.05).The lymphocyte count and percentage, and total T lymphocytes, CD4+ lymphocytes and CD8+ lymphocytes in the T-cell subset of severe group were lower than those of non-severe group, while the levels of lactate dehydrogenase(LDH), C reactive protein, serum amyloid A, and interleukin-6 in severe group were higher than those in non-severe group(P < 0.01).The results of logistic regression analysis showed that the LDH level increasing was a risk factor in the exacerbation of patients with COVID-19, and the CD4+ lymphocytes decreasing was the protective factors.ConclusionsThe changes of many laboratory indexes in patients with COVID are significant, which has some reference value in the assessment of the disease severity, especially for the severe patients with the LDH increasing and CD4+ lymphocytes decreasing.