新型冠状病毒肺炎COVID-19的临床特征与CT表现

目的:探讨2019新型冠状病毒肺炎的(COVID-19)的临床表现、实验室检查及胸部CT特征,加深临床对该病的认识,提高民众和医院对突发公共卫生事件的认识和防控能力。方法:对已确诊的12例COVID-19患者进行高分辨CT检查及三维重建,对其临床表现、实验室检查、胸部CT特征进行分析和总结。结果:确诊病例临床表现以发热、干咳为主;实验室检查结果主要为白细胞减少,淋巴细胞计数及百分比降低,血清C反应蛋白(CRP)增高,肌酶、肝酶和乳酸脱氢酶不同程度增高;胸部CT特征主要表现为双肺胸膜下多发散在磨玻璃样密度影(GGO)、病变多位于胸膜下、肺野外带及双肺后部,局部可见"铺路石征"、"支气管充气征",支气管壁增厚等征象,胸腔积液及淋巴结增大相对较为少见。结论:COVID-19患者的临床表现主要为发热和/或咳嗽,胸部CT表现双肺外周和后肺有明显的磨玻璃影,伴有白细胞正常或减少;实验室检查及胸部CT表现有助于COVID-19患者的早期筛查、诊断和治疗评估。

The Clinical Features and CT Manifestations of the Novel Coronavirus Pneumonia COVID-19

Objective:To investigate novel coronavirus pneumonia(COVID-19) clinical manifestations, laboratory tests and chest CT features, and to deepen clinical understanding of the disease and to improve the awareness and prevention ability of public and hospital for public health emergencies. Methods:High resolution CT and three-dimensional reconstruction were performed in 12 patients with covid-19. The clinical manifestations, laboratory tests and chest CT features were analyzed and summarized. Results:The clinical manifestations of the confirmed cases were mainly fever and dry cough. The results of laboratory examination were mainly leucopenia, the decrease of lymphocyte count and percentage, the increase of serum C-reactive protein(CRP), the increase of muscle enzyme, liver enzyme and lactate dehydrogenase in varying degrees. The CT features of the chest were mainly distributed under the pleura of both lungs ground glass opacities(GGO) and lesions are mostly located under the pleura, in the field zone of the lung and the back of both lungs. Signs such as "paving stone sign", "bronchial inflation sign" and bronchial wall thickening can be seen locally. Pleural effusion and lymph node enlargement are relatively rare. Conclusions:The main clinical manifestations of patients with covid-19 are fever and/or cough. The CT findings of the chest show that there are obvious GGO in the peripheral and posterior lungs of both lungs, accompanied by normal or reduced leukocytes. Laboratory examination and CT findings of the chest are helpful for the early screening, diagnosis and treatment evaluation of patients with covid-19.