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利用基于常规实验室检测的诊断模型来区分感染 SARS-CoV-2 的患者与感染流感病毒的患者。

Using a diagnostic model based on routine laboratory tests to distinguish patients infected with SARS-CoV-2 from those infected with influenza virus.

机构信息

Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan, China.

出版信息

Int J Infect Dis. 2020 Jun;95:436-440. doi: 10.1016/j.ijid.2020.04.078. Epub 2020 May 1.

Abstract

BACKGROUND

The differential diagnosis between novel coronavirus pneumonia patients (NCPP) and influenza patients (IP) remains a challenge in clinical practice.

METHODS

Between January 2018 and March 2020, 1,027 NCPP and 1,140 IP were recruited from Tongji hospital. Routine blood examination, biochemical indicators and coagulation function analysis were simultaneously performed in all participants.

RESULTS

There was no sex predominance in NCPP. The NCPP were frequently encountered in the sixth and seventh decades of life. The mean age of NCPP (56±16 years) was higher than IP (47±17 years), but without statistical difference. Although most results of routine laboratory tests between NCPP and IP had no significant differences, some laboratory tests showed an obvious change in NCPP. It was observed that NCPP had significantly decreased white blood cells, alkaline phosphatase and d-dimer compared with IP. However, the results of lactate dehydrogenase, erythrocyte sedimentation rate and fibrinogen were significantly increased in NCPP compared with IP. The diagnostic model based on a combination of 18 routine laboratory indicators showed an area under the curve of 0.796 (95% CI, 0.777-0.814), with a sensitivity of 46.93% and specificity of 90.09% when using a cut-off value of 0.598.

CONCLUSIONS

Some routine laboratory results had statistical difference between NCPP and IP. A diagnostic model based on a combination of routine laboratory results provided an adjunct approach in the differential diagnosis between NCPP and IP.

摘要

背景

新型冠状病毒肺炎患者(NCPP)与流感患者(IP)的鉴别诊断在临床实践中仍然具有挑战性。

方法

2018 年 1 月至 2020 年 3 月,从同济医院共招募了 1027 例 NCPP 和 1140 例 IP。所有参与者均同时进行常规血液检查、生化指标和凝血功能分析。

结果

NCPP 无性别优势。NCPP 多见于六七十岁。NCPP 的平均年龄(56±16 岁)高于 IP(47±17 岁),但无统计学差异。尽管 NCPP 和 IP 之间的大多数常规实验室检查结果无显著差异,但一些实验室检查显示 NCPP 有明显变化。与 IP 相比,NCPP 的白细胞、碱性磷酸酶和 D-二聚体显著降低。然而,NCPP 的乳酸脱氢酶、红细胞沉降率和纤维蛋白原结果明显高于 IP。基于 18 项常规实验室指标组合的诊断模型的曲线下面积为 0.796(95%CI,0.777-0.814),当使用 0.598 作为截断值时,敏感性为 46.93%,特异性为 90.09%。

结论

NCPP 和 IP 之间的一些常规实验室结果存在统计学差异。基于常规实验室结果组合的诊断模型为 NCPP 和 IP 的鉴别诊断提供了一种辅助方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cc5/7194039/17245260f440/gr1_lrg.jpg

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