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新型冠状病毒肺炎患者肝脏和胰腺密度与胸部 CT 评分进展及实验室检查结果的关系。

The Relationship of Liver and Pancreas Density With Chest Computed Tomography Score Progression and Laboratory Findings in Patients With COVID-19.

机构信息

From the Department of Radiology, Fethi Sekin City Hospital, Elazig.

Department of Radiology, Faculty of Medicine, Izmir Democracy University, Izmir.

出版信息

J Comput Assist Tomogr. 2022;46(6):848-853. doi: 10.1097/RCT.0000000000001354. Epub 2022 Jul 14.

Abstract

OBJECTIVE

Abdominal involvement of COVID-19 is a current issue. We aimed to evaluate hepatic and pancreatic density alterations on computed tomography (CT) and to analyze whether these alterations had a relationship with chest CT score and laboratory findings.

METHODS

Patients with reverse transcription-polymerase chain reaction-confirmed COVID-19 from March 11, 2020, to February 6, 2021, were retrospectively analyzed. Patients were divided into nonprogressive and progressive groups according to their chest CT scores. Liver and pancreas density, and liver-to-spleen (L/S) ratio were calculated. Laboratory findings, medication, intensive care unit stay, and survival were noted.

RESULTS

There were 51 patients in the nonprogressive group and 123 patients in the progressive group. The median (minimum to maximum) L/S value of the nonprogressive group was 1 (0.28-1.53) at admission and 1.06 (0.33-1.83) at follow-up ( P < 0.001). In the progressive group, the median L/S value was 1.08 (0.35-1.51) at admission and 0.92 (0.33-1.75) at follow-up ( P < 0.001). A significant difference was found between the 2 groups at admission and follow-up ( P = 0.010 and P < 0.001, respectively). Pancreatic density measured at follow-up was significantly lower in the progressive group ( P = 0.045). In the progressive group, aspartate aminotransferase, total bilirubin, creatinine, urea, C-reactive protein, D-dimer, and white blood cell values were higher; albumin and lymphocyte values were lower ( P < 0.05).

CONCLUSIONS

Patients with COVID-19 with progressive CT scores may have a decrease in L/S values, and their pancreatic density is lower than nonprogressives. Aspartate aminotransferase, total bilirubin, creatinine, urea, C-reactive protein, D-dimer, and white blood cell values tend to be higher in patients with a high chest CT score.

摘要

目的

COVID-19 的腹部受累是一个当前的问题。我们旨在评估腹部 CT 上的肝和胰腺密度改变,并分析这些改变与胸部 CT 评分和实验室检查结果之间是否存在关系。

方法

对 2020 年 3 月 11 日至 2021 年 2 月 6 日期间经逆转录-聚合酶链反应(RT-PCR)确诊的 COVID-19 患者进行回顾性分析。根据胸部 CT 评分,将患者分为非进展组和进展组。计算肝脏和胰腺的密度以及肝脾比值(L/S)。记录实验室检查、药物使用、入住重症监护病房(ICU)和生存情况。

结果

非进展组有 51 例患者,进展组有 123 例患者。非进展组入院时(最小值到最大值)中位数(M)(最小值到最大值)L/S 值为 1(0.28-1.53),随访时为 1.06(0.33-1.83)( P < 0.001)。进展组入院时的 L/S 值为 1.08(0.35-1.51),随访时为 0.92(0.33-1.75)( P < 0.001)。两组入院时和随访时的 L/S 值均有显著差异( P = 0.010 和 P < 0.001)。进展组胰腺密度在随访时显著降低( P = 0.045)。进展组的天冬氨酸氨基转移酶、总胆红素、肌酐、尿素、C 反应蛋白、D-二聚体和白细胞值较高,白蛋白和淋巴细胞值较低( P < 0.05)。

结论

COVID-19 患者胸部 CT 评分进展者 L/S 值可能降低,且胰腺密度较非进展者低。胸部 CT 评分较高者天冬氨酸氨基转移酶、总胆红素、肌酐、尿素、C 反应蛋白、D-二聚体和白细胞值较高,白蛋白和淋巴细胞值较低。

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