江汉大学学报（自然科学版） ›› 2021, Vol. 49 ›› Issue (2): 5-11.doi: 10.16389/j.cnki.cn42-1737/n.2021.02.001

• COVID-19 研究 • 上一篇    下一篇

474例新冠住院患者临床特征及重症危险因素分析

殷紫薇1，朱虹*2，凃乾1   

  1. 1. 江汉大学 医学院，湖北 武汉 430056；2. 武汉市中心医院，湖北 武汉 430014
  • 发布日期:2021-03-19
  • 作者简介:殷紫薇（1994— ），女，住院医师，硕士生，研究方向：全科医学。
  • 基金资助:
    ZHU Hong

Clinical Characteristics and Severe Risk Factors of COVID- 19 Patients：A 474-Case Study

YIN Ziwei1，ZHU Hong*2，TU Qian1   

  1. 1. School of Medicine，Jianghan University，Wuhan 430056，Hubei，China；2. The Central Hospital of Wuhan，Wuhan 430014，Hubei，China
  • Published:2021-03-19
  • Contact: 朱虹

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摘要： 目 的 探究与新冠重型/危重型（重症）患者可能相关的风险指标，旨在能早期识别具有重型/危重型高风险指标的患者并及时做出适当的干预和调整。方 法 共纳入474 例患者各项临床数据，回顾性观察轻型/普通型与重型/危重型一般特征、基础疾病、临床症状、入院实验室检查结果以及转归的差异。采用二元logistics 模型进行多因素分析，探究与发展为重型/危重型可能相关的危险因素。结 果 重型/危重型患者病死率更高，年龄更大，病程更长。305 名患者合并慢性基础疾病，单因素研究发现重型/危重型患者中性粒细胞计数、血尿素氮（BUN）、纤维蛋白原、D- 二聚体、超敏C 反应蛋白（CRP）、降钙素原、肌酸激酶同工酶、乳酸脱氢酶（LDH）更高，淋巴细胞计数、血小板计数、单核细胞计数、白蛋白、白球比、总蛋白降低，两组间具有明显统计学差异（P < 0. 01）。多因素二元logistic 分析结果显示合并慢性基础疾病OR = 1. 706，95%CI（1. 074，2. 709），P = 0. 024；淋巴细胞计数OR = 0. 521，95%CI（0. 342，0. 792），P = 0. 002；BUN OR = 1. 054，95%CI（1. 001，1. 110），P = 0. 044；CRP OR = 1. 107，95%CI（1. 024，1. 197），P = 0. 011；LDH OR = 1. 004，95%CI（1. 001，1. 007），P = 0. 007。均为P < 0. 05。结 论 COVID-19 住院患者合并慢性基础病，BUN、CRP、LDH 越高，淋巴细胞计数越低患者发展为重型/危重型的风险增加，对住院患者可加强监测、及时调整治疗方案。

关键词: 新冠肺炎, SARS-CoV-2, 临床特征, 危险因素

Abstract: Objective To explore the risk factors that may be related to severe/critical COVID-19 patients，so as to early identify patients with severe/critical high-risk indicators and make appropriate interventions and adjustments in a timely manner. Methods A total of 474 patients were included in the study. The differences in general characteristics，underlying diseases，clinical symptoms，laboratory findings and outcomes between mild/normal and severe/critical patients were observed retrospectively. The binary logistics model was used for multi-factor analysis to explore the risk factors that may be related to the development of severe/critical type. Results Severe/critically patients had higher mortality，older age and longer hospital stays. There were 305 patients complicated with pre-existing comorbidities，and single factor study found that neutrophil count， the levels of blood urea nitrogen（BUN），fibrinogen，D-dimer，CRP，procalcitonin，creatine kinase isoenzyme and lactate dehydrogenase were higher in severe/critical patients. However，lymphocyte count，platelet count，macrophage count，albumin，globulin ratio and total protein were lower，and there was a significant difference between the two groups（P < 0. 01）. Multivariate binary logistic analysis showed that the patients complicated with pre-existing comorbidities OR = 1. 706，95%CI（1. 074，2. 709），P = 0. 024. Lymphocyte count OR = 0. 521，95%CI（0. 342，0. 792），P = 0. 002；BUN OR = 1. 054，95%CI（1. 001，1. 110），P = 0. 044；CRP OR = 1. 107，95%CI（1. 024，1. 197），P = 0. 011；LDH OR = 1. 004，95% CI（1. 001，1. 007），P = 0. 007. Conclusion There is a higher risk of developing into severe/critical cases for the COVID-19 patients complicated with pre-existing comorbidities and laboratory examination results suggest that the higher levels of BUN，CRP，LDH，and lower lymphocyte count. Therefore，monitoring and treatment regimens of patients in the hospital could be strengthened and timely adjusted.

Key words: COVID-19, SARS-CoV-2, clinical characteristics, risk factors

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