2019新型冠状病毒肺炎早期临床特征分析

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目的 总结分析2019新型冠状病毒肺炎(NCP)患者早期的临床和影像学特征.方法 回顾性分析2020年1月18日至2020年2月3日北京清华长庚医院发热门诊确诊的9例新型冠状病毒感染患者的临床和影像学资料.结果 9例患者中男5例,女4例,年龄15~48岁,中位年龄为36岁.其中8例患者无基础疾病,1例有糖尿病.7例患者均有武汉或湖北旅行史,1例患者为医务人员,出现两起家庭聚集性发病.潜伏期1~6 d,临床表现为发热8例,干咳5例,咽痛4例,乏力4例,全身酸痛4例,鼻塞流涕1例.6例患者外周血常规异常,其中3例单核细胞计数升高,2例淋巴细胞计数降低,1例白细胞计数升高,3例血常规完全正常.5例患者外周血C反应蛋白(CRP)轻度升高,4例患者CRP正常,中位数为16.3 mg/L.5例患者行降钙素原检查均为阴性.3例患者行X线胸片检查,1例无异常,1例表现为右上肺渗出影,1例表现为有下肺渗出影.9例患者均行胸部高分辨率CT(HRCT)检查:其中7例表现为肺部多发的磨玻璃样渗出影,累及双肺5例,累及单侧肺2例,3例伴有斑片状实变影,2例无异常.结论 在北京发热门诊就诊的2019新型冠状病毒感染患者一般具有明确的流行病学史,临床主要表现为发热和咳嗽,外周血白细胞计数正常,降钙素原阴性,胸部HRCT表现为多发的磨玻璃影、部分病灶伴有实变,部分患者X线胸片正常而胸部HRCT显示为肺炎,部分患者无肺炎表现.“,”Objective To summarize and analyze the clinical and imaging characteristics of patients with 2019 novel coronavirus pneumonia in the early stage in Beijing.Methods A retrospective analysis of clinical and imaging data of 9 patients with 2019 novel coronavirus infection diagnosed in one fever clinicic in Beijing from January 18,2020 to February 3,2020.Results 5 male and 4 female was included in those 9 patients,whose median age was 36 years,and the age range from 15 to 49 years.8 of these patients had no underlying disease and one suffered from diabetes.7 patients had a history of travel to Wuhan City or Hubei Province,and one patient was a medical staff.Two family clustered was found.The incubation period was 1 to 6 days.The clinical manifestations were fever in 8 cases (8/9),dry cough in 5 cases (5/9),pharyngalgia in 4 cases (4/9),fatigue in 4 cases (4/9),body soreness in 4 cases (4/9),and blocked or watery nose in 1 case (1/9).Six patients(6/9) had abnormal cell peripheral blood,of which 3 (3/9) had an increased monocyte count,2 (2/9) had a reduced lymphocyte,and 1 (1/9) had an increased leukocyte count,while the 3 patients had normal cell blood routines.The median of CRP was 16.3 mg/L,including 5 patients with slightly elevated (5/9),4 patients with normal values (4/9).the results of procalcitonin test were negative in5 patients.Three patients were examined by chest X-ray examination,one of which was normal,one case showed infiltrates of right upper lung,and another showed in right lower lung.All patients underwent chest HRCT.And 7 cases (7/9) showed multiple ground glass exudation,including 5 cases (5/7) involved bilateral lungs,2 cases (2/7) involved unilaterallung,3 cases (3/7) with patchy consolidation,and 2 cases (2/9) showed no abnormality.Conclusions The patents with 2019 novel coronavirus pneumonia in this study generally have an epidemiological history.The clinical manifestations are fever and cough.Peripheral white blood cell counts were most normal And PCT were all negative.Chest HRCT manifested as multiple ground-glass opacities with partly consolidation.Some patients had normal chest radiographs but HRCT showed pneumonia.Some patients had no pneumonia on chest HRCT.
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