[1]王素娜,姚 娜,汪春付,等.新型冠状病毒肺炎39例临床特征分析*[J].陕西医学杂志,2020,49(6):643-647652.[doi:DOI:10.3969/j.issn.10007377.2020.06.001]
　WANG Suna,YAO Na,WANG Chunfu,et al.Epidemiological and clinical characteristics of COVID-19 in Shaanxi,China[J].,2020,49(6):643-647652.[doi:DOI:10.3969/j.issn.10007377.2020.06.001]
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新型冠状病毒肺炎39例临床特征分析*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年6期
页码:
643-647652
栏目:
“新型冠状病毒肺炎”专题
出版日期:
2020-06-05

文章信息/Info

Title:
Epidemiological and clinical characteristics of COVID-19 in Shaanxi,China
作者:
王素娜; 姚 娜; 汪春付; 杜 虹; 孙永涛; 康文臻; 连建奇; 郝春秋; 康 文△
空军军医大学第二附属医院(唐都医院)传染科(西安710038)
Author(s):
WANG Suna; YAO Na; WANG Chunfu; et al.
Department of Infectious Diseases,Tangdu Hospital,the Air Force Medical University( Xi'an 710038)
关键词:
严重急性呼吸综合征冠状病毒2;  新型冠状病毒肺炎;  流行病学特征;  临床特征;  疾病严重程度;  核酸检测
Keywords:
Severe acute respiratory syndrome corona virus 2;  Corona virus disease 2019;  Epidemiologic characteristics;  Clinical features;  Disease severity;  Nucleic acid detection
分类号:
R511
DOI:
DOI:10.3969/j.issn.10007377.2020.06.001
文献标志码:
A
摘要:
目的:分析新型冠状病毒肺炎(COVID-19)流行病学特点和临床特征。方法:选取2020年1月21日至2月17日在唐都医院隔离病房收治的COVID-19患者39例,收集其临床资料,分析一般情况、临床症状、血液检验及CT影像学特征,分析其人口学特征和实验室指标与疾病临床分型的关系。结果:39例患者中,男性 24例(61.5%),女性 15 例(38.5%),年龄 22～83岁,平均(53.54±15.91)岁。武汉或其他地区输入病例21例(53.8%),本地病例18例(46.2%)。本地病例中,61.1%(11/18)为家庭聚集性病例,分属7个家庭。合并有基础疾病者22 例(56.4%),合并两种以上基础病患者8例(20.5%); 危重型患者有心血管疾病史的比例最高(61.5%)。临床表现主要为发热34例(87.1%),畏寒4例(11.8%),干咳 20 例(51.3%),胸闷、呼吸困难 13 例(33.3%),乏力和肌肉酸痛 14 例(35.9%)。实验室检查血白细胞总数正常或减低 33 例(84.6%),淋巴细胞计数减少 29例(74.4%); 危重型患者血清ALT、AST和CRP水平均较轻型、普通型组升高。除3例轻型患者外,其余36例患者CT均表现为双侧肺炎,其中9例伴有少量胸腔积液。所有重型及危重型患者均予 α-干扰素雾化吸入联合洛匹那韦/利托那韦片治疗; 25例患者吸氧(64.1%),11例无创机械通气(28.2%),8例转ICU(20.5%),其中3例患者因呼吸衰竭行气管插管有创机械通气及俯卧位通气。截至撰稿时,39例患者均存活,12位患者已治愈出院。结论:本地区确诊的COVID-19患者多数为输入病例,本地病例有明显的家庭聚集性。重型、危重型患者年龄更大、合并基础疾病更多,淋巴细胞计数减少、CRP升高、转氨酶异常更常见。
Abstract:
Objective:To describe the epidemiological and clinical characteristics of corona virus disease 2019(COVID-19)in Shaanxi Province. Methods:This study retrospectively analyzed the general situation,clinical symptoms,blood test and CT imaging characteristics of 39 hospitalized patients with confirmed COVID-19 in Tangdu Hospital of the Air Force Medical University in Shaanxi,China,from January 21 to February 17,2020. And the relationship between demographic characteristics,laboratory indexes and clinical classification of the desease were analyzed. Results:Of the 39 patients,24 were male(61.5%)and 15 were female(38.5%),aged 22-83 years,with an average(53.54±15.91)years of age. Twenty-one cases(53.8%)were imported from Wuhan or other regions,and 18 cases(46.2%)were locals. Among these 18 local cases,11 of them(61.1%)were family clustering,who were from 7 families. Twenty-two patients(56.4%)had underlying conditions,and 8 of them(20.5%)were with more than two underlying conditions. The proportion of severe patients with a history of cardiovascular disease(61.5%)was the highest. Clinical manifestations were fever(34/39,87.1%),chills(4/39,11.8%),dry cough(20/39,51.3%),chest tightness and dyspnea(13/39,33.3%),fatigue and muscle soreness(14/39,35.9%). Laboratory tests showed that the peripheral white blood cell counts was normal or decreased in 33 cases(84.6%),and the lymphocyte counts decreased in 29 cases(74.4%). The levels of serum alanine aminotransferase,aspartate aminotransferase and C-reactive protein in severe group were higher than that of mild and ordinary group. Chest computed tomography showed bilateral involvement in 36 patients,and 9 of them accompanied by a small amount of pleural effusion. All critical ill patients were treated with interferon-aerosolized inhalation combined with lopinavir/ritonavir orally. Oxygen inhalation or noninvasive ventilation was given in 25(64.1%)or 11(28.2%)patients,respectively. Eight patients(20.5%)required intensive care unit treatment,and three of them had invasive ventilation and intermittent prone ventilation due to respiratory failure. As of writing,12 patients were discharged and 27 are under isolation and treatment in hospital.Conclusions:Most of the COVID-19 cases in Shaanxi Province are imported and family clustering cases. Older people and people with underlying conditions seem to be at greater risk of serious illness. Lymphocytopenia,elevation of CRP and ALT was more common in severe patients.

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备注/Memo

备注/Memo:
*国家科技重大专项(2017ZX10204401-002-005);陕西省重点研发计划项目(2020ZDXM-SF-003)
更新日期/Last Update: 2020-07-28