广州市47例新型冠状病毒肺炎恢复期患者肺功能研究

目的了解47例新型冠状病毒肺炎(COVID-19)患者恢复期肺功能状况,分析新型冠状病毒对肺的损伤程度,为COVID-19致肺损伤恢复提供实验依据。方法选取2020年1月—2月在广州市第八人民医院治愈出院,隔离14 d后的47例COVID-19恢复期患者为研究对象,对检测肺功能、胸部CT、新型冠状病毒抗体结果进行回顾性分析。结果 47例恢复期COVID-19患者新型冠状病毒IgM阴性40例(占85.1%),IgG阳性44例(占93.6%),其中IgM、IgG均阳性7例,IgM、IgG均阴性3例。肺功能损障碍29例(占61.7%),其中轻度、中度障碍分别19例、10例。限制性通气功能障碍3例,阻塞性通气功能障碍1例,通气功能障碍2例,混合通气功能障碍1例,弥散功能障碍26例,弥散并限制性通气功能障碍2例,弥散并阻塞性通气功能障碍1例,弥散并通气功能障碍2例,小气道功能障碍共5例。11例重型COVID-19患者肺功能障碍10例(占90.9%),其中轻度4例,中度6例,36例普通型患者肺功能障碍19例(占52.8%),其中轻度15例,中度4例,两组对比重型COVID-19患者中度肺功能障碍较普通型多。恢复期患者胸部CT异常35例,多表现为弥漫大片状磨玻璃样影、散在斑片影、纤维条索影;其中表现为弥漫大片磨玻璃影和纤维条索影者共8例,中度肺功能障碍患者(7例)较轻度肺功能障碍患者多(1例),重型患者(6例)较普通型患者(2例)多。结论 COVID-19患者恢复期绝大部分患者有肺功能障碍,多表现为弥散功能障碍,对指导康复治疗有一定临床意义。

Pulmonary function of 47 patients with COVID-19 in recovery period in Guangzhou

Objective To explore and understand the injury degree of human lung induced by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),through retrospectively analysis of the 47 patients’pulmonary function in the period of recovery from COVID-19.Methods Totally 47 COVID-19 patients treated in Guangzhou Eighth People's Hospital from January to February 2020,and isolated 14 days were selected as the research subjects.The detected results of pulmonary function,chest CT,and SARS-CoV-2 antibodies were retrospectively analyzed.Results In the 47 COVID-19 convalescent patients,40(85.1%)showed negative for IgM of SARS-CoV-2 and 44(93.6%)showed positive for IgG,7 showed positive for both IgM and IgG,and 3 showed negative for both IgM and IgG.29 cases(61.7%)of pulmonary dysfunction,of which there were 19 mild,10 moderate,3 restrictive ventilation dysfunction,1 obstructive ventilation dysfunction,2 ventilation dysfunction,1 mixed ventilation dysfunction,26 diffusion ventilation dysfunction,2 mixed diffusion &restrictive ventilation dysfunction,1 mixed diffusion &obstructive ventilation dysfunction,2 mixed diffusion &ventilation dysfunction,and 5 small airway dysfunction.10 cases(90.9%)of pulmonary dysfunction in 11 severe COVID-19 patients,of which 4 were mild and 6 were moderate;19 cases(52.8%)of pulmonary dysfunction in 36 general COVID-19 patients,of which 15 were mild and 4 were moderate;Comparing the two groups,the cases of pulmonary dysfunction in severe COVID-19 patients were more than general patients.35 cases of abnormal chest CT in convalescent patients.The abnormal chest CT image mostly showed diffuse large ground glass-like shadows,scattered patchy shadows,and fiber strand shadows;8 cases showed diffuse large ground glass and fiber strand shadows,of which 7 from moderate pulmonary dysfunction VS 1 from mild pulmonary dysfunction,6 from severe COVID-19 patients VS 2 from general patients.Conclusions The majority of patients with COVID-19 in the recovery period have pulmonary dysfunction,which mostly manifests as diffuse dysfunction.The exploration is of certain clinical significance for guiding rehabilitation treatment.