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比较心脑血管疾病(CCVD)和非 CCVD 患者的 COVID-19 临床特征和治疗方法。

Comparison of the clinical features and therapeutics of COVID-19 in cardio-cerebrovascular disease (CCVD) and non-CCVD patients.

机构信息

Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, 310053, China.

Department of Chemistry, Zhejiang University, Hangzhou, 310027, China.

出版信息

Front Med. 2021 Aug;15(4):629-637. doi: 10.1007/s11684-020-0825-2. Epub 2021 Apr 28.

DOI:10.1007/s11684-020-0825-2
PMID:33909258
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8079836/
Abstract

Cardio-cerebrovascular disease (CCVD) is a major comorbidity of Coronavirus disease 2019 (COVID-19). However, the clinical characteristics and outcomes remain unclear. In this study, 102 cases of COVID-19 from January 22, 2020 to March 26, 2020 in Xixi Hospital of Hangzhou were included. Twenty cases had pre-existing CCVD. Results showed that compared with non-CCVD patients, those with CCVD are more likely to develop severe disease (15% versus 1%), and the proportion of pneumonia severity index grade IV was significantly higher (25% versus 3.6%). Computed tomography images demonstrated that the proportion of multiple lobe lesion involvement was significantly higher in the CCVD group than in the non-CCVD group (90% versus 63.4%). Compared with non-CCVD group, the levels of C-reactive protein, fibrinogen, D-dimer, and serum amyloid-A were higher, whereas the total protein and arterial partial PaO were lower in the CCVD group. Although no statistical difference was observed in the outcomes between groups, CCVD patients received more intensive comprehensive treatment to improve COVID-19 symptoms compared with non-CCVD patients. Integrated Chinese and Western medicine treatments have certain advantages in controlling the severe conversion rate and mortality of COVID-19. In addition, given that COVID-19 patients are usually related to coagulation disorders and thrombosis risk, the application of Chinese medicine in promoting blood circulation and removing stasis should be strengthened.

摘要

心脑血管疾病(CCVD)是 2019 年冠状病毒病(COVID-19)的主要合并症。然而,其临床特征和结局仍不清楚。在本研究中,纳入了 2020 年 1 月 22 日至 2020 年 3 月 26 日杭州西溪医院的 102 例 COVID-19 病例。其中 20 例存在 CCVD 既往史。结果显示,与非 CCVD 患者相比,CCVD 患者更易发展为重症(15%对 1%),且肺炎严重指数(PSI)分级Ⅳ的比例明显更高(25%对 3.6%)。计算机断层扫描(CT)图像显示,CCVD 组多叶病变受累的比例明显高于非 CCVD 组(90%对 63.4%)。与非 CCVD 组相比,CCVD 组的 C 反应蛋白、纤维蛋白原、D-二聚体和血清淀粉样蛋白 A 水平更高,而总蛋白和动脉部分氧分压(PaO)更低。虽然两组间的结局无统计学差异,但与非 CCVD 组相比,CCVD 患者接受了更强化的综合治疗,以改善 COVID-19 症状。中西医结合治疗在控制 COVID-19 重症转化率和死亡率方面具有一定优势。此外,鉴于 COVID-19 患者通常与凝血障碍和血栓形成风险相关,应加强中药在促进血液循环和祛瘀方面的应用。

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