2019新型冠状病毒肺炎不同临床类型ct与临床特征的相关性研究

Q4 Medicine
Lu Huang, R. Han, Pengxin Yu, Shao-hua Wang, L. Xia
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引用次数: 10

摘要

目的探讨2019年新型冠状病毒肺炎的CT及临床特点。方法回顾性分析2020年1月确诊的103例2019年新型冠状病毒肺炎患者的胸部CT和临床资料。根据新型冠状病毒肺炎的诊断和治疗(试验5),将所有患者分为轻型(n=58)、重型(n=36)和非常重型(n=9),并对其临床表现、实验室检查和CT表现进行分析。CT表现包括病变的分布、位置、大小、形状、边缘、数量、密度、肺炎病变在全肺的百分比和肺外表现。采用χ2检验或Fisher精确概率对不同临床亚型的CT特征进行比较。通过方差分析(正态分布)或Kruskal-Wallis秩和检验(非正态分布。结果从临床表现来看,重症新冠肺炎患者以老年男性为主,中位年龄65岁。在58名新冠肺炎患者中,49名(84%)患者以发烧为首发症状,重症和危重症患者均以发烧为第一症状。重症(25/36,69%)和危重症(6/9,67%)NCP患者的咳嗽发生率高于普通患者(20/58,34%)。所有危重病人都有呼吸困难。在CT表现方面,常见的NCP表现为双肺(40/58,71%)多发(40/58,69%)毛玻璃(31/58,52%)或混合(25/58,43%)病变(56/58,97%);重型和危重型NCP表现为双肺病变,重型NCP主要表现为多发性(34/36,96%)斑块(33/36,92%)混合密度病变(26/36,72%);9例严重NCP病变为大于3cm的混合密度病变。肺炎病灶占全肺容量的百分比:普通型(12.5%±6.1%)显著低于重型(25.9%±10.7%)和危重型(47.2%±19.2%)NCP,差异有统计学意义(P值分别<0.001和0.002),严重型NCP也明显低于危重型(P=0.032)。胸部CT表现具有独特的特点,不仅可以早期诊断,还可以评估其临床病程和严重程度。关键词:冠状病毒感染;肺炎;层析成像,X射线计算机
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A correlation study ofCT and clinical features of different clinical types of 2019 novel coronavirus pneumonia/ 中华放射学杂志
Objective To investigate the CT and clinical features of 2019 novel coronavirus (NCP) pneumonia. Methods Chest CT and clinical data of confirmed 103 patients with 2019 novel coronavirus pneumonia in January 2020, retrospectively. According to diagnosis and treatment of NCP infected pneumonia (trial version 5), all the patients were classified into mild(n=58), severe (n=36) and very severe (n=9) type, and their clinical findings, laboratory examination and CT finding were analyzed. CT features included lesions’ distribution, location, size, shape, edge, number, density, percentage of pneumonia lesions of the whole lung and extra-pulmonary manifestations. The CT features of different clinical subtypes were compared using χ2test or Fisher's exact probability. Comparisons between the percentage of pneumonic lesions to total lung volume were computed by using analysis of variance (normal distribution) or Kruskal-Wallis rank sum test (non-normal distribution). Results In terms of clinical manifestations, the patients with severe NCP were more common in elderly men, with a median age of 65 years. Fever was the first symptom in 49 (84%) of 58 patients with NCP, and fever was the first symptom in both severe and critical NCP patients. The incidence of cough in severe (25 / 36, 69%) and critical (6 /9, 67%) NCP patients was higher than that in general (20 /58, 34%). All critical patients have dyspnea. In terms of CT findings, common NCP showed double lung (40/58,71%) multiple (40 / 58,69%) ground glass (31/58,52%) or mixed (25 / 58,43%) lesions (56 / 58,97%); severe and critical NCP showed double lung lesions, heavy NCP mainly showed multiple (34 / 36,96%) patches (33 / 36,92%) mixed density lesions (26 / 36,72%); 9 severe NCP lesions were more than 3 cm Mixed density lesions. The percentage of pneumonia focus in the whole lung volume: the common type (12.5% ± 6.1%) was significantly lower than the severe type (25.9% ± 10.7%) and the critical type (47.2% ± 19.2%) NCP, the difference was statistically significant (P values were < 0.001 and 0.002 respectively), and the severe type NCP was also significantly lower than the critical type (P = 0.032). Conclusions CT and clinical features of different clinical types of NCP pneumonia are different. Chest CT findings have unique characteristic, which can not only make early diagnosis, but also evaluate its clinical course and severity. Key words: Coronavirus infection; Pneumonia; Tomography, X-ray computed
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来源期刊
Zhonghua fang she xue za zhi Chinese journal of radiology
Zhonghua fang she xue za zhi Chinese journal of radiology Medicine-Radiology, Nuclear Medicine and Imaging
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