新型冠状病毒肺炎患者的影像与实验室检测指标分析

目的:分析新型冠状病毒肺炎患者的胸部表现与实验室检测指标。方法:回顾性分析2020年1月22日至2月17日我院收治的105例新型冠状病毒肺炎患者的实验室检测指标及影像检查结果,分析各项血常规检测指标及血气分析指标的异常变化、胸部CT影像表现。结果:105例新型冠状病毒肺炎患者多数表现出血沉、淀粉样蛋白A(SSA)、C反应蛋白、乳酸脱氢酶(LDH)、D-二聚体(D-D)水平异常升高,少数患者凝血酶原时间异常升高,降钙素原水平异常升高,极少数患者表现出中性粒细胞、白细胞、淋巴细胞异常升高或异常降低;患者多数表现出氧分压(PO2)水平异常降低,但总体PO2水平升高;部分患者表现出二氧化碳分压(PC02)水平异常升高,但并未影响总体PC02水平。PH总体水平表现正常。治疗前行CT检查,主要表现为两肺以小叶内间隔增厚为主的片状磨玻璃影、片状渗出实变影,以双肺胸膜下明显。经治疗好转后复查CT,显示患者实变影明显减少,网格影及条索影明显增加,磨玻璃影贯穿疾病始终,影像滞后于临床。结论:新型冠状病毒肺炎患者的多项血常规及血气分析指标会出现明显异常,且CT片检查可较好地反映病变的动态变化,对实验室指标进行动态监测,结合CT检查结果可帮助指导临床诊断与治疗。

Imaging and Laboratory Examination of Patients with COVID-19

Objective:To analyze the imaging and laboratory detection indexes of patients with COVID-19. Methods:The laboratory test indexes and imaging results of 105 patients with COVID-19 admitted to our hospital from January 22 to February 17, 2020 were retrospectively analyzed, the abnormal changes of blood routine test indexes and blood gas analysis indexes were analyzed, and the chest CT images were analyzed. Results:of the 105 patients, Most patients infected with COVID-19 presented with increase of erythrocyte sedimentation rate(ESR), amyloid A(SS A), C-reactive protein(CRP), lactate dehydrogenase(LDH) and D-dimer level. A few of patients with increase of prothrombin time and procalcitonin level. besides, very few patients showed abnormal increase or decrease of neutrophils, leukocytes and lymphocytes. Moreover, most of patients showed of oxygen partial pressure(PO₂) level decrease, but the PO₂ level increased. The PCO₂ increased in some patients but with normal total PCO₂ level. PH level in all patients were normal. Before treatment, the main manifestation of chest CT were lamellar ground glass opacity, lamellar exudate solid shadow and mainly located in the double lung subpleural. After treatment, the solid shadow decreased obviously, but mesh opacity and linear opacities increased. The ground glass opacity still exit in all patients after treatment. Conclusion:the blood routine and blood gas analysis indexes of COVID-19 patients would be abnormal, and the CT scan could better reflect the dynamic changes of the lung lesion. The dynamic monitoring of laboratory and CT scan could help to guide the clinical diagnosis and treatment.