| 燕丛,刘启明,张毛为,等.新型冠状病毒奥密克戎变异株感染后肺间质病变的半年随访观察[J].安徽医药,2025,29(10):2041-2047. |
| 新型冠状病毒奥密克戎变异株感染后肺间质病变的半年随访观察 |
| Observation of pulmonary interstitial lesions in patients after infection with the Omicron variant of COVID-19: a six-month follow-up study |
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| DOI：10.3969/j.issn.1009-6469.2025.10.026 |
| 中文关键词: 新型冠状病毒感染 奥密克戎 肺间质纤维化 影像学特征 随访研究 |
| 英文关键词: Novel coronavirus pneumonia Omicron Pulmonary interstitial fibrosis Imaging features Follow-up study |
| 基金项目:江苏省卫健委医学科研面上项目( H2023005)；江苏省高校重点实验室开放课题项目( XZSYSKF2022004)；江苏省研究生科研与实践创新计划( SJCX24_1544)；徐州市科技项目( KC22269)；徐州市医学重点人才项目( XWRCHT20220063) |
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| 中文摘要: |
| 目的观察新型冠状病毒变异株奥密克戎( Omicron)感染后肺间质病变的演变，探索进展为纤维化样改变的危险因素。方法纳入 2022年 12月至 2023年 2月徐州医科大学附属医院确诊新型冠状病毒变异株 Omicron感染的成年病人 109例，收集影像学表现、实验室检查指标、合并基础疾病、治疗用药等临床资料，前瞻性随访病人感染半年时的影像学表现，观察肺间质病变的影像学演变情况，并对随访结果进行统计学分析。结果新型冠状病毒变异株 Omicron感染半年后的电子计算机断层扫描( CT)中， 23.9%(26/109)表现出完全放射学缓解， 76.1%(83/109)残余间质改变，其中 45(41.3%)观察到纤维化样的征象(支气管扩张 /扭曲、网状影、实质带和 /或蜂窝影)。急性期局限性肺气肿相互比较，半年后有肺纤维化样改变组 40.0%(18/45)高于无肺纤维化样改变组 12.5%(8/64)(P<0.05)。多因素 logistic回归分析确定了发病急性期 CT扫描中小叶间隔增厚［OR=3.23， 95%CI:(1.09，9.54)， P=0.034］、局限性肺气肿［OR=4.87，95%CI:(1.77，13.40)， P=0.002］、 CRP≥50 mg/L［OR=3.00，95%CI:(1.25，7.22)，P=0.014］作为新型冠状病毒感染半年后肺纤维化样变化的独立预测因子。结论新型冠状病毒变异株 Omicron感染恢复期半年后多数病人遗留有肺间质异常改变，其中 41.3%出现纤维化样改变。急性期 CT出现小叶间隔增厚及局限性肺气肿肺部基础、 C反应蛋白 ≥50 mg/L对半年后存留肺部纤维化样改变有一定预测价值。 |
| 英文摘要: |
| Objective To observe the disease progression of pulmonary interstitial lesions after the infection with the Omicron variant of COVID-19 and to explore the risk factors for progression to fibrosis-like changes.Methods A total of 109 adult patients diagnosed with the infection with Omicron variant of COVID-19 in The Affiliated Hospital of Xuzhou Medical University from December 2022 toFebruary 2023 were enrolled. Clinical data including imaging manifestations, laboratory examination indexes, comorbidities, and medi-cations were collected. The imaging manifestations of patients at 6-month post-infection were prospectively followed up to observe the imaging evolution of pulmonary interstitial lesions, and the follow-up results were statistically analyzed.Results Of computed tomogra-phy (CT) scans half a year after infection with the Omicron variant of COVID-19, 23.9% (26/109) showed complete radiological remis-sion, and 76.1% (83/109) had residual interstitial changes, among which 45 (41.3%) showed fibrotic signs (bronchiectasis/tortuosity, re-ticular shadows, parenchymal bands and/or honeycomb shadows). Half a year after the infection, the rate of acute-stage localized emphy-sema in the group with pulmonary fibrosis-like changes was 40.0% (18/45), higher than 12.5% (8/64) in the group without pulmonary fi-brosis-like changes (P<0.05). Multivariate logistic regression analysis identified the following in CT scans at the initial stage of the dis-ease as independent predictors of pulmonary fibrosis-like changes half a year after the infection: thickening of the septal septum [OR= 3.23,95%CI:(1.09,9.54),P=0.034], localized emphysema [OR=4.87,95%CI:(1.77,13,40),P=0.002], and C-reative protein (CRP)≥50 mg/ L[OR=3.00,95%CI:(1.25,7.22),P=0.014].Conclusions In the six-month follow-up of chest CT in patients infected with the Omicron variant of COVID-19, most patients have abnormal pulmonary interstitial changes, among which 41.3% has fibrosis-like changes. Thickened interlobular septum and pulmonary base of localized emphysema found in acute-phase CT imaging, and CRP ≥50 mg/L have certain predictive value for residual pulmonary fibrosis-like changes six months after the infection. |
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