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| 新型冠状病毒肺炎与流感病毒肺炎临床特征对比研究 |
| Comparative study on clinical features of newcoronavirus pneumonia and influenza virus pneumonia |
| 投稿时间：2020-03-28 |
| DOI：10.3969/j.issn.1000-0399.2020.04.001 |
| 中文关键词: 新型冠状病毒 肺炎 流感病毒 症状 影像学 |
| 英文关键词: New coronavirus Pneumonia Influenza Symptoms Imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨新型冠状病毒肺炎(COVID-19)与流感病毒肺炎(IVP)病例临床表现、实验室指标和影像学特征之间的差异。方法 选取2020年1月20日～2月22日六安市人民医院确诊的COVID-19患者62例纳入COVID-19组,选取排除COVID-19且确诊为IVP患者31例纳入IVP组,比较分析两组患者的临床症状、体征、血常规、生化指标、炎症指标,以及肺部CT影像学病灶的性状、分布、累及的肺段数量等资料的差异。结果 COVID-19组患者中咳痰比例11.29% (7例),低于IVP组38.71%(12例);COVID-19组患者β-2微球蛋白>3.0 pg/mL比例为48.39%(30例),高于IVP组25.81%(8例),差异均有统计学意义(P均<0.05)。COVID-19组患者肺部CT影像病灶形态表现为磨玻璃影比例91.94%(57例),高于IVP组29.03%(9例),呈现片絮影比例1.61%(1例),低于IVP组74.19%(23例),差异均有统计学意义(P<0.05)。COVID-19组病灶分布多位于肺野外侧带、胸膜下,高于IVP组[56.45%(35例）比 9.68%(3例）]，病灶散在分布表现高于IVP组[40.32%(25例) 比 9.68%(3例）];病灶呈双侧肺野分布比例82.26%(51例),高于IVP组35.48% (11例),差异均有统计学意义(P均<0.05);COVID-19组病灶累及肺段数目≥10个比例为32.26%(20例),高于IVP组3.22%(1例),差异有统计学意义(P<0.05)。结论 IVP表现咳痰较COVID-19多;COVID-19患者β-2微球蛋白升高更多;肺部CT影像多表现斑片磨玻璃影,病灶多呈双肺散在分布,多位于肺野外侧带(胸膜下),累及肺段较多,而IVP多表现密度稍高的片絮影,病灶多沿细支气管纹理分布,累及肺段相对较少。 |
| 英文摘要: |
| Objective To investigate the differences in clinical manifestations, laboratory indicators, and imaging characteristics between novel coronavirus pneumonia (COVID-19) cases and influenza virus pneumonia (IVP) cases. Methods Sixty-two patients diagnosed with COVID-19 between January 20, 2020 and February 22, 2020 were selected as COVID-19 group, while thirty-one patients diagnosed with influenza virus pneumonia and excluded from new coronavirus infection as IVP group. The clinical symptoms, signs, blood routine, biochemical indicators, inflammatory indicators, the character and distribution of lung lesion, number of lung segments affected by the virus in lung CT imaging were compared and analysed between the two group. Results The proportion of cough with expectoration in COVID-19 group was 11.29% (7 cases), which was significantly lower than that in IVP group 38.71% (12 cases) (P<0.05). The proportion of β-2 microglobulin > 3.0 pg/ml in COVID-19 group was 48.39%(30 cases), which was significantly higher than that in IVP group 25.81% (8 cases) (P<0.05). The proportion of the character of lung lesion in lung CT imaging showed by glass mill in COVID-19 group was 91.94% (57 cases), significantly higher than 29.03%(9 cases) in IVP group, and that showed by flakes in COVID-19 group was 1.61%(1 case), significantly lower than 74.19% (23 cases) in IVP group. The proportion of the distribution of lung lesion in lung CT imaging showed by locating in lateral zone of lung field and subpleural area in COVID-19 group was 56.45% (35 cases), apparently higher than 9.68% in IVP group (3 cases), and that showed by diffused distribution in COVID-19 group was 40.32% (25 cases), markedly higher than that of IVP group (9.68%)(3 cases), and that showed by bilateral lung field was 82.26% (51 cases), significantly higher than that of IVP group 35.48% (11 cases) (P<0.05).The proportion of the number of lung segments affected by the virus≥10 in lung CT imaging in COVID-19 group was 32.26% (20 cases),which was significantly higher than 3.22%(1 case) in IVP group (P<0.05). Conclusions Patients with IVP have more cough with sputum than COVID-19; β-2 microglobulin increases more in COVID-19 patients. CT images of lungs in COVID-19 patients show mostly patchy glass shadows, and the lesions are mostly distributed in both lungs, most of which are located in the lateral zone of the lung field or under the pleura, with more involvement of the lung segment, while IVP usually shows a slightly higher density of flakes, and the lesions are mostly distributed along the bronchiole texture, with relatively less involvement of the lung segment. |
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