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投稿时间：2022-12-21 网络发布日期：2023-07-19
投稿时间：2022-12-21 网络发布日期：2023-07-19
中文摘要: 目的 分析运城市新型冠状病毒肺炎（新冠肺炎）患者的临床特征及治疗情况。方法 回顾性分析2022年10月7日至11月10日山西省运城市定点医院330例新冠肺炎患者的临床资料，其中无症状感染者157例，轻型145例，普通型17例，重型11例。比较患者的一般资料及治疗情况。结果 与其他三型相比，重型患者年龄高，100%并存基础疾病，合并恶性肿瘤占比高，差异有统计学意义（P＜0.05）；重型患者疫苗接种率（36.4%）低于无症状感染者（77.1%）、轻型（81.4%）、普通型（88.2%），差异有统计学意义（P＜0.05）；重型患者淋巴细胞计数、CD4+T淋巴细胞绝对计数降低，C反应蛋白、D二聚体升高，差异有统计学意义（P＜0.05）。重型患者未使用药物占比最低，应用胸腺法新、奈玛特韦/利托那韦、康复期血浆比例最高。结论 无基础疾病的人群感染新冠肺炎后，轻型及无症状感染可能性大；高龄、恶性肿瘤是重型新冠肺炎的高危因素，多需抗病毒药物联合中药、增强免疫药物等治疗。体内淋巴细胞水平、CD4+T淋巴细胞绝对计数、C反应蛋白及D二聚体可能与新冠肺炎严重程度相关。通过接种疫苗使机体产生保护性抗体IgG，提高人群疫苗接种率，疫苗覆盖高龄、恶性肿瘤人群，是降低新冠肺炎重型感染行之有效的措施。
Abstract:Objective To analyze the clinical characteristics and treatment of 330 patients with novel coronavirus disease 2019(COVID-19) in Yuncheng City to provide some reference for clinical decision-making.
Methods A retrospective analysis was performed on the the data of 330 patients with COVID-19 treated in Yuncheng designated hospitals from October 7 to November 10, 2022.There were 157 cases of asymptomatic infections, 145 cases of mild infections, 17 cases of common infections and 11 cases of severe infections. The general information, clinical characteristics and treatment of patients were observed and compared.
Results
Compared with the patients with asymptomatic infections, mild infections and common infections, the patients with severe infection were older, with 100% of them having underlying diseases and a higher proportion of malignant tumors, with the statistical differences in them(P＜0.05）.The vaccination rates were respectively 36.4% in severe patients, 77.1% in asymptomatic patients, 81.4% in mild patients and 88.2% in common patients, and there were the significant differences in it among the different types of patients(P＜0.05). In severe patients, the lymphocyte count and the absolute CD4+T lymphocyte counts significantly decreased, and the levels of C-reactive protein and D-dimer increased significantly compared with those in other types of patients(P＜0.05). The proportion of severe patients without medication was the lowest, and the proportion of application of thymalfasin and nimatevir/ritonavir and convalescent plasma were the highest during rehabilitation. Conclusion The persons without underlying diseases are more likely to be infected with mild and asymptomatic infection of COVID-19. Older age and malignant tumors are the high risk factors of severe COVID-19, which needs to be treated with antiviral drugs combined with Chinese medicine and immuno-enhancing drugs. Lymphocyte level, CD4+T lymphocyte absolute count, CRP and D-dimer may be related to the severity of COVID-19 infection. Vaccination can produce protective antibody IgG and is an effective measure to reduce the severe infection of COVID-19.
keywords: Novel coronavirus disease 2019 Severe illness Vaccine Lymphocytes Thymalfasin Namatvir/Litonavir
文章编号： 中图分类号：R511 文献标志码：B
基金项目:山西省卫生健康委新冠肺炎科研项目（2020-11）；山西省新型冠状病毒疫情防控科研攻关项目（202003D31014/GZ）〖
附件
| 作者 | 单位 |
| 张宏1 | 1. 山西医科大学第一临床医学院，山西 太原 030001； |
| 曹大伟2 | 2. 山西医科大学第一医院呼吸与危重症医学科，山西 太原 030001； |
| 张新日2 | 2. 山西医科大学第一医院呼吸与危重症医学科，山西 太原 030001 |
| Author Name | Affiliation |
| ZHANG Hong*, CAO Dawei, ZHANG Xinri | *The First Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030001, China |
引用文本：
张宏,曹大伟,张新日.运城市新型冠状病毒肺炎330例临床特征及治疗分析[J].中国临床研究,2023,36(7):1060-1064.
张宏,曹大伟,张新日.运城市新型冠状病毒肺炎330例临床特征及治疗分析[J].中国临床研究,2023,36(7):1060-1064.