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中华卫生应急电子杂志 ›› 2020, Vol. 06 ›› Issue (04) : 214 -219. doi: 10.3877/cma.j.issn.2095-9133.2020.04.004

所属专题: 文献

论著

贵阳地区COVID-19患者感染的流行病学及临床特征分析
张曼曼1, 崔德军1,(), 袁文强1, 黄博1, 韩然1, 徐文玲2, 杨丹3, 吴立波4, 陆滢雪5   
  1. 1. 550002 贵州贵阳,贵州省人民医院消化内科
    2. 550002 贵州贵阳,贵州省人民医院呼吸内科
    3. 550002 贵州贵阳,贵州省人民医院检验科
    4. 550002 贵州贵阳,贵州省人民医院肾内科
    5. 550002 贵州贵阳,贵州省人民医院感染科
  • 收稿日期:2020-03-23 出版日期:2020-08-18
  • 通信作者: 崔德军
  • 基金资助:
    贵州省人民医院国家自然科学基金培育基金(黔科合平台人才[2018]5764-11)

Epidemiological and clinical characteristics of patients infected with SARS-CoV-2 in Guiyang

Manman Zhang1, Dejun Cui1,(), Wenqiang Yuan1, Bo Huang1, Ran Han1, Wenling Xu2, Dan Yang3, Liboi Wu4, Yingxue Lu5   

  1. 1. Department of Gastroenterology, Guizhou Provincial People’s Hospital, Guiyang 550002, China
    2. Department of Respiratory Medicine, Guizhou Provincial People’s Hospital, Guiyang 550002, China
    3. Department of Laboratory, Guizhou Provincial People’s Hospital, Guiyang 550002, China
    4. Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang 550002, China
    5. Department of Infectious Diseases, Guizhou, Provincial People’s Hospital, Guiyang 550002, China
  • Received:2020-03-23 Published:2020-08-18
  • Corresponding author: Dejun Cui
  • About author:
    Corresponding author: Cui Dejun, Email:
引用本文:

张曼曼, 崔德军, 袁文强, 黄博, 韩然, 徐文玲, 杨丹, 吴立波, 陆滢雪. 贵阳地区COVID-19患者感染的流行病学及临床特征分析[J/OL]. 中华卫生应急电子杂志, 2020, 06(04): 214-219.

Manman Zhang, Dejun Cui, Wenqiang Yuan, Bo Huang, Ran Han, Wenling Xu, Dan Yang, Liboi Wu, Yingxue Lu. Epidemiological and clinical characteristics of patients infected with SARS-CoV-2 in Guiyang[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2020, 06(04): 214-219.

目的

描述在贵阳地区发现的确诊新型冠状病毒感染肺炎(COVID-19)患者的流行病学和临床特点。

方法

采用回顾性病例分组研究分析2020年1月29日至2月17日贵州省人民医院隔离病房收治的18例COVID-19确诊患者为研究对象进行回顾性病例分析,其中男性9例,女性9例;年龄15 ~ 68岁,平均(43±16.4)岁。收集患者的一般资料和临床资料,分析其流行病学特点、一般情况、临床症状、实验室检查(血常规、血生化以及相关炎性指标)及CT影像学改变特点等;分析轻症与重症患者血清炎性指标之间的差别及与疾病临床分型的关系。

结果

(1)18例患者中,10例(55.6%)为家族聚集性发病;外省(非贵州省)返回人员8例(44.4%),其中湖北返黔人员7例(87.5%),台湾返黔人员1例(12.5%)。(2)患者的主要症状为发热[15例(83.3%)]、呼吸道症状{咳嗽、咳痰[15例(83.3%)],胸闷、呼吸困难[3例(16.7%)]},部分患者伴有腹泻[5例(27.8%)]及其他症状。(3)实验室检查结果以外周血白细胞计数、中性粒细胞计数正常或降低及淋巴细胞计数降低为主要特征,血沉[15例(83%)]、降钙素原(PCT)[10例(56%)]多高于正常范围,部分患者白细胞介素-6(IL-6)可高于正常[7例(39%)]。但多数患者的肝功能、肾功能、心肌酶、C反应蛋白(CRP)的水平未表现出明显异常。与轻症组患者的血清炎症指标相比,重症组患者血清IL-6水平升高[18.34(22.87)pg/mL比1.92(4.37)pg/mL],差异有统计学意义(P<0.05),但CRP、PCT、铁蛋白、乳酸脱氢酶(LDH)、血沉的差异无统计学意义。(4)COVID-19患者大部分有典型的部病变表现,影像学改变特点为病变呈现多发散在斑片状、片状磨玻璃密度影,边缘模糊,部分病变表现为间质性改变,以肺外带为主。

结论

贵阳地区COVID-19确诊患者基本都有

Objective

To describe the epidemiology and clinical characteristics of patients with confirmed new coronavirus infection pneumonia (COVID-19) found in Guiyang.

Methods

Eighteen patients with COVID-19 admitted to the isolation ward of Guizhou Provincial People’s Hospital from January 29 to February 17, 2020 were selected as research subjects. The clinical data of patients were collected and their general situation, clinical symptoms, CT image characteristics were analyzed. According to the relevant diagnostic criteria, the 18 patients were divided into two groups: mild group including the normal type (9 cases), and severe group including severe type and critical type(9 cases). The relationship between serological inflammation and clinical classification of the disease was analyzed by comparing the changes of serological inflammatory markers between the two groups.

Results

The main symptoms of 18 COVID-19 patients were fever and respiratory symptoms, and some of them were accompanied by diarrhea and other symptoms. In peripheral blood examination, there were 16 cases of normal and decreased white blood cells, 16 cases of normal and decreased neutrophils, 7 cases of decreased lymphocyte number, 15 cases of blood sedimentation rate higher than normal, 10 cases of PCT higher than normal, 7 cases of interleukin-6 higher than normal, and no significant changes in liver function, kidney function, myocardial enzyme and CRP. Compared to patients with mild group, levels of serum interleukin-6 in patients with severe group was higher (P<0.05). Serum CRP and PCT in patients with severe group, ferritin, LDH, blood sedimentation were higher than those in mild group of patients, but there was no statistically significant difference (P>0.05). Most of the patients with NCP had typical pulmonary lesions, which were mostly scattered in patchy and patchy ground glass density shadows with blurred edges. Some of the lesions showed interstitial changes, mainly in the peripheral lung of COVID-19 patients.

Conclusions

COVID-19 patients in Guiyang have a clear epidemiological history. The main clinical features are fever and respiratory symptoms, and the clinical symptoms are relatively mild. The counts of serum white blood cells and neutrophils are normal, and the blood biochemistry is basically normal. Almost all of the patients have typical pulmonary lesions on CT. Patients with underlying diseases may easily develop into severe and critical forms. Interleukin-6 has certain clinical significance in clinical classification of COVID-19. Whether serum CRP, PCT, ferritin, LDH and erythrocyte sedimentation rate have clinical significance remains to be further studied.

图1 18 例COVID-19确诊患者的阳性症状和体征分布情况
图2 18 例COVID-19确诊患者的流行病学情况
表1 18 例COVID-19确诊患者的血清学检查结果特点[例(%)]
图3 18 例COVID-19确诊患者轻症组与重症组炎症指标平均值的比较
表2 18 例COVID-19确诊患者轻症组与重症组各指标表达水平的比较
图4 多个肺叶2019-nCoV病毒感染的典型CT影像学改变
图5 2019-nCoV 病毒感染的单个肺叶纤维灶
图6 普通型COVID-19确诊患者治疗前后的CT表现
图7 重型COVID-19确诊患者治疗前后的CT表现
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