成人新型冠状病毒重型肺炎早期预警指标探讨-东南大学学报医学版

成人新型冠状病毒重型肺炎早期预警指标探讨

单位：鹤壁市第三人民医院感染科, 河南鹤壁 458000

分类号：R563.14

出版年·卷·期（页码）：2021·40·第三期（395-398）

摘要：

目的：探讨新型冠状病毒重型肺炎（以下简称新冠肺炎重型）预警指标，提高对重型患者的早期识别能力。方法：回顾性分析2020年1月至2月鹤壁市第三人民医院收治的15例新冠肺炎患者的临床资料，比较临床特征，寻找新冠肺炎重型的预警指标。结果：3例重型患者体质指数高，发生重型前淋巴细胞（LYM）进行性下降，C反应蛋白（CRP）短期下降不明显或上升，重型较普通型患者CRP高，CRP及LYM异常率高，普通型患者同时无基础疾病、CRP及LYM均正常比率高于重型的患者，发生重型时影像学有进展。结论：对于高龄、肥胖、具有慢性基础性疾病及围产期女性等特殊人群，出现低氧血症、外周血LYM进行性下降、CRP进行性升高、乳酸进行性升高及肺部影像学病变迅速进展的任一条件时，应警惕病情恶化的可能。

Objective: To explore the early warning indicators of severe coronavirus disease 2019(COVID-19) and to improve the early identification ability for severe patients. Methods: Retrospective analysis was performed on the clinical data of 15 COVID-19 patients admitted to Hebi Third People's Hospital from January 2020 to February 2020 to compare their clinical characteristics and look for early warning indicators for severe COVID-19. Results: Three patients with severe COVID-19 had high body mass index and progressive decrease of the lymphocyte(LYM) before severe COVID-19, while the short-term decrease of C-reactive protein(CRP) was not obvious or CRP was increased. In severe cases, CRP was higher than that of ordinary patients, with high abnormal rates of CRP and LYM. In ordinary patients, there was no underlying disease at the same time, and the normal rates of CRP and LYM were higher than those of severe patients, and imaging progress was achieved when severe disease occurred. Conclusion: For the elderly, obese, the patients with chronic underlying diseases and perinatal women special groups, in the event of hypoxemia, progressive decrease of perinatal LYM, progressive increase of CRP, progressive increase of lactic acid and rapid progression of pulmonary imaging, the possibility of deterioration should be vigilant.

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