50例普通型新型冠状病毒肺炎患者临床及胸部CT表现的分析

目的 分析50例普通型新型冠状病毒肺炎（COVID-19）患者的流行病学、临床、实验室检测结果及胸部CT表现，为临床诊治提供理论依据。 方法 回顾性分析2020年1至4月于无锡市第五人民医院经实时聚合酶链反应对咽拭子标本检查结果为阳性的50例普通型COVID-19患者其中，男性26例、女性24例，年龄（38.2±19.6）岁]的临床数据和CT资料；同时对患者行薄层胸部CT扫描多平面重建以观察患者的肺部改变，对各肺区受累情况进行评分。计量资料的比较采用Mann-Whitney U检验。计数资料的比较采用卡方检验。 结果 50例普通型COVID-19患者中，40例患者（80%）曾到过武汉或与确诊患者有过接触史，17例（34%）无明显症状，38例（76%）主要表现为发热、咳嗽、乏力。实验室检查结果多数在正常范围内，部分患者出现淋巴细胞计数下降、超敏C反应蛋白水平升高、淋巴细胞百分比下降。典型CT表现主要为磨玻璃影、铺路石征、实变，且肺组织病变以周围型为主，双侧多叶分布。肺前区CT评分明显低于后区（H=?4.096，P=0.003），中、上区CT评分低于下区（H=6.917，P=0.031）。 结论 普通型COVID-19患者的临床表现可能不明显，实验室检查结果可能无明显异常，而胸部CT的改变比较明显，因此临床诊治过程中应充分结合患者胸部CT的表现，密切关注胸部CT的动态变化。

Clinical and chest CT manifestations of 50 patients with common novel corona virus disease 2019

Objectives To analyze the epidemiological, clinical, laboratory test results, and chest CT features of 50 patients with common novel corona virus disease 2019 (COVID-19), so as to provide a theoretical basis for clinical diagnosis and treatment. Methods The clinical manifestations and CT image findings of 50 patients with common novel COVID-19 (including 26 males and 24 females, aged (38.2±19.6) years) who were positive in throat swab samples by real-time polymerase chain reaction in Wuxi Fifth People's Hospital from January to April 2020 were collected and studied retrospectively. In addition, the patients were scanned with thin-layer chest CT and multiplanar reconstruction to observe the changes in their lungs, and the involvement of each lung area was scored. The measurement data were compared by using the Mann-Whitney U test. The Chi-square test was used to compare counting data. Results Of the 50 patients with common novel COVID-19, 40 patients (80%) had been to Wuhan or had a history of contact with confirmed patients, 17 patients (34%) had no evident symptoms, and 38 patients (76%) were primarily characterized by fever, cough and fatigue. The results of laboratory tests are mostly within the normal range, and some patients have shown decreased lymphocyte count, increased level of hypersensitive C-reactive protein, and decreased percentage of lymphocytes. Typical CT manifestations primarily include ground-glass shadow, paving stone sign and consolidation, and lung tissue lesions are primarily of peripheral type, with bilateral lobular distribution. The CT score of the anterior lung area was significantly lower than that of the posterior lung area (H=?4.096, P=0.003), and the CT score of the middle and upper lung area was lower than that of the lower lung area (H=6.917, P=0.031). Conclusions Patients with common novel COVID-19 may not have evident clinical manifestations, and their laboratory results may have no obvious abnormalities, but the change in chest CT is relatively evident. Therefore, patient's chest CT performance and dynamic changes in chest CT should be combined to obtain accurate clinical diagnosis and treatment.