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2019冠状病毒病患者CT扫描与高敏C反应蛋白及D-二聚体的相关性

Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019.

作者信息

Zhu Jin, Chen Cheng, Shi Rongshu, Li Bangguo

机构信息

Jin Zhu, Department of Intervention, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, P.R. China.

Cheng Chen, Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, P.R. China.

出版信息

Pak J Med Sci. 2020 Sep-Oct;36(6):1397-1401. doi: 10.12669/pjms.36.6.2961.

Abstract

OBJECTIVES

To study the correlations of CT scan with high-sensitivity C-reactive protein (hs-CRP) and D-dimer in patients with coronavirus disease 2019 (COVID-2019).

METHODS

From January to March 2020, COVID-19 patients were divided into two groups according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial version 7), with mild and ordinary cases as Group-1 and critical and severe cases as Group-2. The chest CT scan results, hs-CRP, D-dimmer levels of the two groups from admission to discharge were compared by the χ test or Fisher's exact test. The quantitative data were represented as mean ± standard deviation ( x ± s). Intergroup comparisons were performed by the independent samples t test, and the ineligible data were subjected to the nonparametric rank sum test. Binary logistic regression model was used for multivariate correlation analysis, using independent variables that were significant in univariate analysis. The correlations between the above indices were analyzed.

RESULTS

In Group-1, there were two cases of normal chest CT scan results, one case of fibrosis, and 25 cases of abnormalities during the first diagnosis, mainly manifested as single or scattered ground-glass shadows. After treatment, the CT scan results became normal. The chest CT scan of Group-2 showed abnormalities, including 21 cases of multiple ground-glass shadows, and six cases of multiple consolidations accompanied by ground-glass shadows, who were critically ill and died. In addition, there were 16 cases of multiple ground glass shadows with partial consolidation, and the CRP and D-dimer levels of Group-2 were significantly higher than those of Group-1. Chest CT scan results were significantly positively correlated with CRP and D-dimer levels (P<0.05).

CONCLUSION

The chest CT scan results of COVID-19 patients are characteristic, being correlated with CRP and D-dimer levels. D-dimer and CRP levels significantly increase in most severe and critical patients, which are closely related to their prognosis. The indices may play predictive roles in clinical treatment and prognosis evaluation.

摘要

目的

研究2019冠状病毒病(COVID-19)患者CT扫描与高敏C反应蛋白(hs-CRP)及D-二聚体的相关性。

方法

2020年1月至3月,根据《新型冠状病毒肺炎诊疗方案(试行第七版)》将COVID-19患者分为两组,轻症和普通型病例为第一组,危重症和重型病例为第二组。采用χ检验或Fisher确切概率法比较两组患者入院至出院时的胸部CT扫描结果、hs-CRP、D-二聚体水平。定量资料以均数±标准差(x±s)表示。组间比较采用独立样本t检验,不符合条件的数据采用非参数秩和检验。采用二元logistic回归模型进行多因素相关性分析,以单因素分析中有统计学意义的自变量作为独立变量。分析上述指标之间的相关性。

结果

第一组患者首次诊断时胸部CT扫描结果正常2例,纤维化1例,异常25例,主要表现为单发或散在磨玻璃影。治疗后CT扫描结果恢复正常。第二组患者胸部CT扫描均有异常,其中多发磨玻璃影21例,多发实变伴磨玻璃影6例,均为危重症患者且死亡。另外,多发磨玻璃影伴部分实变16例,第二组患者的CRP和D-二聚体水平显著高于第一组。胸部CT扫描结果与CRP和D-二聚体水平呈显著正相关(P<0.05)。

结论

COVID-19患者胸部CT扫描结果具有特征性,与CRP和D-二聚体水平相关。多数重型和危重症患者D-二聚体和CRP水平显著升高,与预后密切相关。这些指标在临床治疗及预后评估中可能具有预测作用。

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