摘要
目的回顾分析本地区COVID-19患者,探讨其临床特征、疗效及转归。方法收集安徽医科大学附属安庆医院北院区(安庆市传染性医院)2020年1月22日至2月23日收治的COVID-19确诊患者83例,其中轻型5例、普通型77例、重型1例。按流行病学分为有武汉暴露史组和无武汉暴露史组,两组病例均按国家卫健委发布的新型冠状病毒感染的肺炎诊疗方案进行诊治,将相关实验室检测、胸部CT、治疗方案及预后等资料进行统计分析。结果83例患者中,47例有武汉暴露史,36例无武汉暴露史。通过及时有效的综合诊疗,全部患者临床治愈出院。两组患者大多以发热、干咳、乏力等为首发症状,白细胞、淋巴细胞正常或轻度下降。胸部CT大多为特征性斑片、磨玻璃影改变,经治疗后均吸收好转。从首发症状出现到口咽拭子核酸检测连续2次(采样时间至少间隔24 h)阴转的中位时间是17天。两组病例经治疗后病灶均明显吸收好转。两组患者的临床特征、实验室检测、胸部CT、临床治疗及预后等相关数据经统计学分析,差异无明显统计学意义。结论COVID-19普通型有特征性临床及影像学表现,首发症状到核酸转阴的中位时间对抗病毒疗程和解除隔离时机有借鉴意义,及时有效的综合治疗能够达到临床治愈。初步表明SARS-CoV-2在人群传播过程中病毒致病性未见明显改变。
Objective To retrospectively analyze patients diagnosed with COVID-19 in Anqing area on their clinical characteristics,curative effect and outcome. Methods Eighty-three patients diagnosed as COVID-19 from Jan 22 to Feb 23,2020 in Anqing Hospital North Branch of Anhui Medical University(Anqing City Infectious Hospital)were analyzed,including 5 mild cases,77 common cases and one severe case.They were divided into 2 groups based on the exposure history of Wuhan city.Patients were diagnosed and treated according to the new pneumonia diagnostic and treatment guideline issued by the National Health Commission.Their relevant laboratory tests,CT images,treatment regimens and prognosis were compared between the two groups. Results Of the 83 patients,47 had an exposure history of Wuhan and 36 had no exposure history.Through timely comprehensive treatment,all patients were cured clinically and discharged.Most of the patients in the two groups had fever and dry cough as the first symptoms,their leukocytes and lymphocytes were normal or slightly decreased.Most of the lung CT showed characteristic interstitial inflammatory changes which were improved or disappeared after treatment. The median time from the first symptom to the nucleic acid test of oropharyngeal swab two consecutive times(sampling time interval at least 24 h)was 17 days.The clinical characteristics,laboratory tests,chest CT,clinical treatment and prognosis between the two groups showed no significant statistical difference. Conclusion The COVID-19 common type has characteristic clinical and imaging manifestations,and the median time from the first symptom to the nucleic acid turning negative is of reference to the course of treatment against virus and the time to remove isolation. Timely and effective comprehensive treatment can clinically cure the disease.The preliminary statistical analysis indicated that the pathogenicity of SARS-Co V-2 virus did not change significantly in the process of human transmission.
作者
杨延国
胡长青
施炜
张弦
黄利娟
周和平
YANG Yan-guo;HU Chang-qing;SHI Wei;ZHANG Xian;HUANG Li-juan;ZHOU He-ping(Department of Respiratory,Anhui Medical University,Anqing 246003,Anhui Province,China;Department of Neurosurgery,Anqing Hospital,Anhui Medical University,Anqing 246003,Anhui Province,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2020年第4期539-545,共7页
Fudan University Journal of Medical Sciences
基金
中央高校基本科研业务费专项资金(YD9110002008,YD9110002002)。
