| 武润苗,苟琪玲,魏益群,等.重症新型冠状病毒感染危险因素及影像变化分析[J].安徽医药,2024,28(8):1563-1568. |
| 重症新型冠状病毒感染危险因素及影像变化分析 |
| Risk factors and imaging feature changes of the severe COVID-19 |
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| DOI：10.3969/j.issn.1009-6469.2024.08.016 |
| 中文关键词: 新型冠状病毒感染 重症 危险因素 胸部 CT影像 |
| 英文关键词: COVID-19 Severe Risk factors Chest computed tomography (CT) imaging |
| 基金项目:陕西省重点研发计划项目( 2024SF-YBXM-086)；陕西省人民医院科技发展孵化基金项目( 2023YJY-71)；陕西省人民医院科技人才支持计划项目( 2023JY-20) |
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| 中文摘要: |
| 目的分析重症新型冠状病毒感染( COVID-19)的危险因素及胸部 CT影像变化特点。方法选取 2021年 12月 21日至 2022年 1月 31日在西安市定点医院 ICU治疗的新型冠状病毒感染病人 40例，分为普通组 22例和重症组 18例，回顾两组病人一般资料、血常规、并发症和胸部 CT影像特点及演变情况，并应用多因素 logistic回归分析重症新型冠状病毒感染的危险因素。结果与普通组相比，重症组病人年龄更高［ 67.50(64.0，80.0)岁比 60.5(43.0，66.0)岁］，疫苗接种剂量更少，发病至入院时间更长［ 3(2，5)d比 2(1，3)d］、入院至肺部病灶明显进展时间更短［( 4.44±2.28)d比( 6.59±1.97)d］入院 1周时淋巴细胞比率(LY%)更低［(12.26±7.33)%比( 18.49±5.72)%］并发症更多(尤其肝功能损害、低蛋白血症、 D-二聚体，升高及电解质紊乱)，差异有统计学意义( P<0.05)。重症组胸部 CT更易出，现病变分布为始发灶累及更多肺叶，尤其波及左肺上叶、右肺上叶和右肺中叶，及存在非胸膜下病灶；病变特点为肺实变和支气管充气征，组间比较，差异有统计学意义( P<0.05)。多因素 logistic回归分析显示，入院至肺部病灶明显进展时间、始发灶累及肺叶数和并发症个数与重型新型冠状病毒感染明显相关( P<0.05)。结论始发灶累及肺叶数和并发症个数与 COVID-19的严重程度呈正相关，入院至肺部病灶明显进展时间与 COVID-19的严重程度呈负相关。 |
| 英文摘要: |
| Objective To analyze the risk factors for severe COVID-19 and the imaging feature changes of the chest CT.Methods Clinical data of 40 patients diagnosed as COVID-19 and treated in ICU of Xi'an designated hospitals from December 21, 2021 to Janu-ary 31, 2022 were selected. The patients were divided into normal group (n=2) and severe group (n=18). The general information, bloodcount, chest CT imaging features changes, and complications of the two groups were statistically analyzed. Risk factors for severe COV-ID-19 patients was analyzed by using logistic regression analysis.Results Compared with normal group, the patients of severe group were older [67.50(64.0, 80.0) vs. 60.5(43.0,66.0)], fewer dose of vaccine, longer time of onset to admission [3(2,5)d vs. 2(1,3)d], shorter time from admission to obvious progression of pulmonary inflammatory [(4.44±2.28)d vs. (6.59±1.97)d], lower lymphocyte ratio (LY%) at 1 week after admission [(12.26±7.33)% vs. (18.49±5.72)%], more complications (especially impairment of liver function,hypoalbu- minemia,higher D-dimer levels,electrolyte imbalance) (P<0.05). The severe group was more likely to have the following chest CT fea-tures than the normal group: A for the distribution of the lesions, more lobes were affected initially, especially the left upper lobes, theright upper lobes, and the right middle lobes, with some lesions were not close to the pleura; Pattern of abnormality (consolidation, airspace opacities) (P<0.05). Multiple logistic regression analysis showed that shorter time from admission to obvious progression of pulmo-nary inflammatory, more lobes were affected initially, and more complications were the risk factors for severe COVID-19 (P<0.05).Con- clusion The number of lobes affected initially and the number of complications are positively correlated with the severity of COVID-19, and the time from admission to obvious progression of pulmonary inflammatory is negatively correlated with the severity of COVID-19. |
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