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    普通型向重型演变的新型冠状病毒肺炎病人的危险因素分析

    Analysis of the risk factors of the common type evolving into severe type COVID-19

      摘要
    • 摘要:
      目的 探讨新型冠状病毒肺炎（COVID-19）病人普通型向重型演变的临床危险因素。
      方法 收集24例普通型向重型演变COVID-19病人的临床资料（演变组），分析临床特征、血液检验、炎性指标、胸部CT影像学特征及抗病毒治疗，并与同期41例普通型病人（普通型组）的临床资料进行比较，分析COVID-19病人普通型向重型演变的可能危险因素。
      结果 临床特征，演变组在合并基础疾病和呼吸频率上与普通型组比较差异有统计学意义（P<0.05），但在性别、年龄和临床症状上2组病人差异无统计学意义（P>0.05）。血液学检验结果分析，演变组淋巴细胞计数和血浆白蛋白明显低于普通型组（P<0.05），演变组血糖和尿素明显高于普通型组（P<0.05）。但在白细胞计数、血小板计数及丙氨酸氨基转移酶差异均无统计学意义（P>0.05）。演变组炎性指标明显高于普通型组（P<0.05）。COCID-19普通型病人影像学表现为双肺磨玻璃阴影、斑片状影及实变影，双肺弥漫性磨玻璃阴影伴支气管充气征，两肺大面积实变影伴肺间质改变更易向重型演变，临床应重视。两种抗病毒药物联合和三种药物联合，在演变组和普通型组间差异无统计学意义（P>0.05）。
      结论 COVID-19普通型向重型演变的可能危险因素有合并基础疾病、呼吸频率、淋巴细胞计数、血糖、白蛋白、尿素水平、炎症因子和影像学表现。

       

      Abstract:
      Objective To investigate the clinical risk factors of common type evolving into severe type corona virus disease 2019 (COVID-19).
      Methods The clinical data of 24 patients with common type evolving into severe type COVID-19 were collected(evolution group), the clinical characteristics, blood test results, inflammatory indexes, chest CT imaging characteristics and antiviral treatment were analyzed, which was compared with the clinical data of 41 patients with common type COVID-19 patients(common type group).The possible risk factors of COVID-19 patients developing from common type to severe type were analyzed.
      Results For the clinical characteristics between evolution group and common type group, the differences of the complication with underlying disease and respiratory rate were statistically significant(P<0.05), and the differences of the sex, age and clinical symptoms were not statistically significant(P>0.05).The results of blood test showed that the lymphocyte counts and plasma albumin level in evolution group were significantly lower than those in common type group(P<0.05), the blood glucose and urea levels in evolution group were significantly higher than those in common type group(P<0.05), and the differences of the white blood cell count, platelet count and alanine aminotransferase levels between two groups were not statistically significant(P>0.05).The inflammatory indexes in evolution group were significantly higher than that in common type group(P<0.05).The double lung ground glass shadow, patchy shadow and consolidation shadow, double lung with diffuse ground glass shadow complicated with bronchogram were the mainly imaging findings of the common type group, and the common type patients with two lung large area consolidation shadow complicated with pulmonary interstitial change were more likely to develop to severe type.The differences of the clinical effects of two and three kinds of drugs treatment between two groups were not statistically significant(P>0.05).
      Conclusions The combination of underlying diseases, respiratory frequency, lymphocyte count, blood glucose, albumin, urea level, inflammatory factors and imaging manifestations are the possible risk factors of common type evolving into severe type COVID-19.

       

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