137例COVID-19患者血常规及部分生化指标与病情严重程度的相关性

doi:10.3969/j.issn.1671-7171.2022.02.005

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摘要【目的】分析新型冠状病毒肺炎(COVID-19)患者的各项血常规和部分血生化等检查指标与病情严重程度的相关性。【方法】回顾性分析2020年1月至3月长沙市第一医院北院(长沙市公共卫生救治中心)收治的137例COVID-19患者的临床资料,其中重症患者(重症组)25例,轻型与普通型患者(非重症组)112例。比较重症组与非重症组患者血常规、肝肾功能、心肌酶、炎症指标(CRP)、凝血功能,通过Logistic回归分析重症COVID-19的早期预警指标。采用受试者工作特征曲线(ROC曲线)分析相关指标评估重型COVID-19的价值。【结果】重症组患者年龄、中性粒细胞百分比(NEU%)、C反应蛋白(CRP)、肌酸激酶(CK)、LDH均高于非重症组患者,淋巴细胞计数(LYM)明显低于非重症组(P<0.05)。Spearman秩相关性检验显示,年龄、NEU%、LYM、CRP、CK及LDH均与重症COVID-19呈显著相关(r_s分别为0.338、0.516、-0.324、0.477、0.567、0.292,均P<0.05)。ROC曲线分析显示,LDH最佳阈值为262.60 U/L,曲线下面积(AUC)为0.924,灵敏度76.0%,特异度95.5%;CRP最佳阈值为34.28 mg/L,AUC为0.856,灵敏度76.0%,特异度86.6%;LYM最佳阈值为0.925×10⁹/L,AUC为0.742,灵敏度76%,特异度 63.4%。LDH、CRP与LYM三者联合分析的AUC为0.944(P<0.05),三者联合检测诊断价值最高。【结论】LDH、CRP、LYM对早期COVID-19病情评估具有较好的价值,且联合分析可以提高早期判断COVID-19重症效能,对临床上早期诊断重型COVID-19具有一定意义。

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关键词 ：冠状病毒感染, 肺炎,病毒性, C反应蛋白质, 淋巴细胞计数, 病人病情

Abstract：【Objective】To investigate the blood routine and biochemical indexes of 139 patients with coronavirus disease COVID-19, and explore the relationship between the indexes and the severity of COVID-19 disease. 【Methods】Clinical data of 137 patients with COVID-19 were collected from the Public Health Treatment Center of Changsha during January to March of 2020. The blood routine, liver and kidney function, myocardial enzymes, inflammation index (CRP), coagulation function and other data were compared between severe (n=25) and non-severe (n=112) COVID-19 patients. Logistic regression was used to analyze the early warning index of severe COVID-19.The value of predicting the progress of LDH, CRP and LYM to heavy COVID-19 was analyzed by using receiver operating characteristic curve (ROC curve). 【Results】 Severe patients had higher levels of age, neutrophil percentage (NEU%), C-reactive protein (CRP), creatine kinase (CK) and lactate dehydrogenase (LDH) than the non-severe patients(P<0.05). Lymphocyte count(LYM)was significantly lower in the severe group than that in the non-severe group(P<0.05).There were no significant differences in sex ratio, days of treatment, white blood cell count(WBC), platelet count(PLT), creatine kinase isoenzyme(CK-MB), total bilirubin(TBIL), alanine aminotransferase(ALB), aspartate aminotransferase (AST), albumin (ALB), creatinine (CREA), blood urea nitrogen (BUN), prothrombin time (PT) between the two groups(P>0.05). The spearman rank correlation test showed that age, NEU%, LYM count, CRP, CK and LDH were all significantly correlated with the severity of COVID-19;The correlation coefficients were 0.338, 0.516, -0.324, 0.477, 0.567 and 0.292, respectively, (P<0.05). ROC curve analysis shows that the optimal threshold for LDH was 262.60 U/L, the area under the curve (AUC) was 0.924, the sensitivity was 76.0%, and the specificity was 95.5%. The optimal threshold for CRP was 34.28 mg/L, the AUC was 0.856, the sensitivity was 76.0% , and the specificity was 86.6%. The optimal threshold of LYM was 0.925×10⁹/L, the AUC was 0.742, the sensitivity was 76%, and the specificity was 63.4%. The AUC of the combined analysis of LDH, CRP and LYM was 0.944 (P<0.05), and the combined detection of the three had the highest diagnostic value.【Conclusion】LDH, CRP and LYM are valuable for early assessment of COVID-19, and their combined analysis can improve the effectiveness of early judgment of COVID-19 severity, which has certain significance for early clinical identification of severe COVID-19.

Key words： Coronavirus Infections Pneumonia,Viral C-Reactive Protein Lymphocyte Count Patient Acuity

收稿日期: 2021-03-12

中图分类号:

R563.12

基金资助:湖南省感染性疾病科临床重点专科建设项目(湘卫医发｛2020｝8号)

通讯作者: **E-mail:1633836831@qq.com

引用本文:

李曾, 李金强, 刘长明, 谢青, 黎增辉, 黎晓武, 刘凤娥. 137例COVID-19患者血常规及部分生化指标与病情严重程度的相关性[J]. 医学临床研究, 2022, 39(2): 176-179.
LI Zeng, LI Jin-qiang, LIU Chang-ming, et al. Relationship of Severity of COVID-19 Sickness with Blood Routine and Biochemical Indexes in 137 Patients. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 176-179.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.02.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I2/176

[1] CHEN N, ZHOU M, DONG X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study[J].Lancet,2020,395(10223):507-513.
[2] 国家卫生健康委员会办公厅,国家中医药管理局办公室.新型冠状病毒感染的肺炎诊疗方案(试行第三版)[J].天津中医药,2020,37(1):1-3.
[3] 国家卫生健康委员会办公厅,国家中医药管理局办公室.新型冠状病毒感染的肺炎诊疗方案(试行第五版)[J].中国中西医结合杂志, 2020,40(2):136-138.
[4] 赵建平.重型及危重型新型冠状病毒肺炎诊疗方案[J].医药导报,2020,39(3):310-313.
[5] LI Q, GUAN X, WU P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia[J].N Engl J Med,2020,382(13):1199-1207.
[6] DREWRY A M, SAMRA N, SKRUPKY L P, et al. Persistent lymphopenia after diagnosis of sepsis predicts mortality[J].Shock,2014 ,42(5):383-391.
[7] 吴强.危重型新型冠状病毒肺炎患者T淋巴细胞亚群分析[J].暨南大学学报(自然科学与医学版),2021,42(1):80-87.
[8] PÓVOA P. C-reactive protein: a valuable marker of sepsis[J].Intensive Care Med,2002,28(3):235-243.
[9] PONTI G, MACCAFERRI M, RUINI C, et al. Biomarkers associated with COVID-19 disease progression[J].Crit Rev Clin Lab Sci,2020 ,57(6):389-399.
[10] LIU K, FANG Y Y, DENG Y, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei province [J].Chin Med J (Engl),2020, 133(9): 1025-1031.
[11] CASTIGLIONI C,VERRIGNI D,OKUMA C,et al. Pyruvate dehydrogenase deficiency presenting as isolated paroxysmal exercise induced dystonia successfully reversed with thiamine supplementation. Case report and mini-review[J].Eur J Paediatr Neurol,2015,19(5):497-503.
[12] JIN Y, YANG H, JI W, et al. Virology, Epidemiology, Pathogenesis, and Control of COVID-19[J].Viruses,2020,12(4):372.