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预防医学  2020, Vol. 32 Issue (9): 886-890    DOI: 10.19485/j.cnki.issn2096-5087.2020.09.006
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新型冠状病毒肺炎普通型和重症病例临床特征比较
程芳, 刘赛朵, 叶新春, 郑世林, 吴特, 张强, 施伎蝉
温州市中心医院南白象院区感染科,浙江 温州 325000
Clinical features of ordinany and severe COVID-19 cases
CHENG Fang, LIU Saiduo, YE Xinchun, ZHENG Shilin, WU Te, ZHANG Qiang, SHI Jichan
Department of Infectious Disease, South White Elephant Division, Wenzhou Central Hospital, Wenzhou, Zhejiang 325000, China
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摘要 目的 比较新型冠状病毒肺炎(COVID-19)普通型和重症病例临床特征,为COVID-19病例诊治和预后评估提供依据。方法 收集2020年1月15日—2月29日温州市中心医院南白象院区收治的77例COVID-19病例的基本信息、临床症状、实验室检测和影像学检查等资料,比较普通型和重症病例的临床特征。结果 77例COVID-19确诊病例中普通型50例,重症27例。重症病例年龄、合并高血压及其他基础性疾病比例均高于普通型病例(P<0.05)。重症病例住院第1~3 d最高体温、体温升高比例、咳嗽、咳痰、黄痰、咯血、胸闷和气促发生率均高于普通型病例(P<0.05)。胸部CT显示,重症病例肺部出现实变、磨玻璃影、斑片影比例以及出现实变肺叶数和病变累计肺叶数均高于普通型病例(P<0.05)。重症病例住院第1~10 d 淋巴细胞计数(LYM)、总T淋巴细胞百分比、CD4+T淋巴细胞(CD4)百分比、CD4计数、CD8+T淋巴细胞(CD8)计数、血红蛋白(Hb)、氧合指数均低于普通型病例;重症病例住院第1~10 d乳酸脱氢酶(LDH)、住院第1~10 d中性粒细胞/淋巴细胞(NLR)、中性粒细胞/CD8(N8R)、谷草转氨酶(AST)、铁蛋白、住院第1周内最高C-反应蛋白(CRP)、D-二聚体均高于普通型病例(P<0.05)。结论 与COVID-19普通型病例比较,重症病例年龄偏大,合并基础性疾病且有高热、气促症状,肺部实变及累及肺叶数较多;淋巴细胞(尤其是CD4)下降明显,LDH、NLR、铁蛋白和CRP均升高。
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程芳
刘赛朵
叶新春
郑世林
吴特
张强
施伎蝉
关键词 新型冠状病毒肺炎重症普通型临床特征    
AbstractObjective To compare the clinical characteristics of ordinary and severe coronavirus disease 2019 ( COVID-19 ) cases, so as to provide basis for the diagnosis, treatment and prognosis. Methods We recruited 77 COVID-19 cases in Wenzhou Central Hospital from January 15 to February 29, 2020, collected their general information, clinical symptoms, laboratory test and CT scan results, and compared the clinical features of ordinary and severe cases. Results There were 50 ordinary cases and 27 severe cases. The age, prevalence of hypertension and other baseline diseases of severe cases were higher than those of ordinary cases ( P<0.05 ) . The maximum body temperature during 1-3 days of hospitalization, proportion of body temperature rising, prevalence of cough, yellow phlegm, hemoptysis, chest tightness and shortness of breath of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The proportion of pulmonary consolidation, glazing and patch shadow, the number of solid changes and the cumulative number of lesions of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The values of LYM during 1-10 days of hospitalization, total T-lymphocyte percentage, CD4 count and percentage, CD8 count, Hb and oxygenation index of severe cases were lower than those of ordinary cases; while the values of LDH and NLR during 1-10 days of hospitalization, N8R, AST, ferritin, CRP during 1-7 days of hospitalization and D-dimer of severe cases were higher than those of ordinary cases ( all P<0.05 ). Conclusions Severe COVID-19 cases have older age, higher prevalence of baseline diseases, fever, shortness of breath symptoms, more lung consolidation and lesions, significantly decreased lymphocyte level ( especially CD4 ) , and increased LDH, NLR, ferritin and CRP.
Key wordscoronavirus disease 2019    severe case    ordinary case    clinical feature
收稿日期: 2020-03-16      修回日期: 2020-05-13      出版日期: 2020-09-10
中图分类号:  R181.3  
基金资助:温州市科技重大专项基于信息化系统构建的新型冠状病毒患者重症化机制及抗病毒治疗研究(ZY202004)
作者简介: 程芳,本科,主治医师,主要从事危重症传染性疾病诊疗工作
通信作者: 施伎蝉,E-mail:shijichan@163.com   
引用本文:   
程芳, 刘赛朵, 叶新春, 郑世林, 吴特, 张强, 施伎蝉. 新型冠状病毒肺炎普通型和重症病例临床特征比较[J]. 预防医学, 2020, 32(9): 886-890.
CHENG Fang, LIU Saiduo, YE Xinchun, ZHENG Shilin, WU Te, ZHANG Qiang, SHI Jichan. Clinical features of ordinany and severe COVID-19 cases. Preventive Medicine, 2020, 32(9): 886-890.
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