不同临床分型的新型冠状病毒肺炎患者影像学表现

doi:10.3969/j.issn.1006-7795.2020.02.024

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (2): 283-289.doi: 10.3969/j.issn.1006-7795.2020.02.024

不同临床分型的新型冠状病毒肺炎患者影像学表现

董力¹, 马茜², 吕晓艳³, 殷小平², 杨雯⁴, 王晓东⁵, 边伟林¹

1. 保定市人民医院放射科, 河北保定 071000;
2. 河北大学附属医院CT/MRI室, 河北保定 071000;
3. 解放军总医院第五医学中心放射科, 北京 100039;
4. 保定市人民医院内科, 河北保定 071000;
5. 保定市人民医院外科, 河北保定 071000

收稿日期:2020-02-21 出版日期:2020-04-21 发布日期:2020-04-16
通讯作者: 殷小平 E-mail:yinxiaoping78@sina.com

Radiological findings of novel coronavirus pneumonia patients with different clinical type

Dong Li¹, Ma Xi², Lyu Xiaoyan³, Yin Xiaoping², Yang Wen⁴, Wang Xiaodong⁵, Bian Weilin¹

1. Department of Radiology, Baoding People's Hospital, Baoding 071000, Hebei Province, China;
2. Department of Computed Tomography/Magnetic Resonance, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China;
3. Department of Radiology, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China;
4. Department of Internal Medicine, Baoding People's Hospital, Baoding 071000, Hebei Province, China;
5. Department of Surgical, Baoding People's Hospital, Baoding 071000, Hebei Province, China

Received:2020-02-21 Online:2020-04-21 Published:2020-04-16

摘要/Abstract

摘要： 目的探讨不同临床分型的新型冠状病毒肺炎（COVID-19）的影像学表现。方法回顾性分析71例COVID-19患者的电子计算机断层扫描（computed tomography，CT）影像资料，分析普通型与重型及危重型患者的临床特点、影像学特点、优势分布以及出现好转时间，并进行统计学分析。结果 71例患者中，轻型12例，普通型45例，重型及危重型14例。临床表现方面，重型及危重型（6/14，42.9%；4/14，28.6%）伴乏力、胸闷及呼吸困难较轻型（0；0）及普通型（2/45，4.4%；0）明显，差异有统计学意义（P值分别为0.001，0.002）；普通型（30/45，66.7%）、重型及危重型（9/14，64.3%）C反应蛋白升高较轻型（2/12，16.7%）明显，差异有统计学意义（P=0.005）。CT表现，病变累及范围超过3个肺叶数：重型及危重型（13/14，92.9%）明显高于普通型（26/45，57.8%）；重型及危重型（12/14，85.7%）病变分布于两肺外周及中心多于普通型（20/45，44.4%）；病变表现为实变、病变内伴小叶间隔增厚，重型及危重型均多于普通型；以上表现两组相比，差异均有统计学意义（P值分别为0.036、0.007、0.004、0.002）。对22例患者进行随访，CT表现达高峰及病情出现好转多发生在发病10 d后（40.9%，45.5%）。结论普通型与重型及危重型COVID-19患者胸部CT在发病部位、病变密度、实变程度等方面具有不同特征，多数COVID-19患者多在发病10 d后好转。

关键词: 新型冠状病毒肺炎, 电子计算机断层扫描, 临床分型

Abstract: Objective To investigate the imaging manifestations of COVID-19 with different clinical types.Methods Computed tomography(CT)imaging data of 71 patients diagnosed with COVID-19 were retrospectively analyzed. The clinical characteristics, imaging characteristics, the dominant distribution of lesions and improvement time of patients with common type,severe type and critically severe type were analyzed statistically. Results Among the 71 patients,12 were mild type, 45 common, 14 severe and critically severe. For the clinical manifestations, critically severe and severe patients had symptoms of fatigue,chest tightness and dyspnea(6/14,42.9%;4/14,28.6%),It was more obvious than those common type(2/45,4.4%;0) and mild type (0;0), with a statistically significant difference (P=0.001, 0.002).The C-creative protein level of patients with common type(30/45,66.7%), severe and critically severe type(9/14,64.3%) was higher than that of mild type(2/12,16.7%), with a statistically significant difference (P=0.005).For the CT manifestations:more than three lobes were involved in the lesions:the ratio(13/14,92.9%) in the severe and the critically severe type was higher than that in the common type(26/45,57.8%). For the severe and the critically severe type, the ratio of (12/14,85.7%) the lesions distribution in the peripheral and central lung was higher than the common type(20/45,44.4%). The lesions including consolidation, interlobular septal thickening in the severe and the critically severe type were more serious than those in the common type. These manifestations showed statistically significant differences between the two groups(P values were 0.036, 0.007, 0.004, 0.002).The followed up of 22 patients indicated that the peak of CT manifestations and the improvement of the condition all occurred 10 days later (40.96%,45.5%).Conclusion COVID-19 patients with common type and those with severe and critically severe type have different characteristics in the location of the lesions, the density of the lesion, the degree of consolidation and so on. Most of the patients may improve after 10 days of onset.

Key words: COVID-19, computed tomography, clinical type

中图分类号:

R445

董力, 马茜, 吕晓艳, 殷小平, 杨雯, 王晓东, 边伟林. 不同临床分型的新型冠状病毒肺炎患者影像学表现[J]. 首都医科大学学报, 2020, 41(2): 283-289.

Dong Li, Ma Xi, Lyu Xiaoyan, Yin Xiaoping, Yang Wen, Wang Xiaodong, Bian Weilin. Radiological findings of novel coronavirus pneumonia patients with different clinical type[J]. Journal of Capital Medical University, 2020, 41(2): 283-289.

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不同临床分型的新型冠状病毒肺炎患者影像学表现

Radiological findings of novel coronavirus pneumonia patients with different clinical type

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