摘要
目的 分析不同预后的新型冠状病毒肺炎(新冠肺炎)胸部CT及临床资料.方法 回顾性纳入新冠肺炎生存组45例及死亡组13例,对临床资料、实验室指标、胸部CT肺部炎症指数(PII)进行统计学分析.结果 两组在淋巴细胞、中性粒细胞与淋巴细胞比值(NLR)、D二聚体、降钙素原、C反应蛋白、白蛋白、氧合指数、乳酸、PII(首次及7-14天复查)上均有统计学差异.二元逻辑回归结果显示:淋巴细胞(OR6.392)、NLR(OR0.933)、氧合指数(OR1.011)、乳酸(ORO.076)、首次PII(OR0.065)在新冠肺炎预后上有统计学差异.逐步多因素回归分析结果显示乳酸是新冠肺炎死亡的独立危险因素(P=0.025)o ROC结果显示:乳酸、PII(首次)+乳酸+NLR三者联合预测新冠肺炎预后的AUC分别为0.875(95％CI 0.755～0.995)、0.895(95％CI 0.755～0.999).结论 乳酸是新冠肺炎预后的独立危险因素,PII(首次)+乳酸+NLR三者联合可能有更好的临床价值.
Abstract
Objective To analyze the chest CT images and clinical data of 2019 novel coronavirus-associated pneumonia(COVID-19)patients with different prognosis.Methods 45 patients in the survival group and 13 patients in the death group diagnosed with COVID-19 pneumonia were enrolled retrospectively.The clinical data,laboratory indicators,and chest CT PII scores were statistically analyzed.Results There were significant differences between the two groups in lymphocytes,Neutrophil to lymphocyte ratio(NLR),D-dimer,procalcitonin,C-reactive protein,albumin,oxygenation index,Lac,PII(first and after 7-14 days).Single logistic regression results showed that lymphocyte(OR 6.392),NLR(OR 0.933),oxygenation index(OR 1.011),lactic acid(OR 0.076),and the first Pll(OR 0.065)had statistical differences in the prognosis of COVID-19.Stepwise multivariate logistic regression analysis showed that Lac was an independent risk factor for death of COVID-19(P=0.025).The results of Receiver operating characteristic analysis(ROC)showed that the area under curve(AUC)of Lac,combination of PII(first time),Lac and NLR were 0.875(95％CI 0.755～0.995)and 0.895(95％CI 0.755～0.999)respectively,in predicting the prognosis of COVID-19 pneumonia.Conclusion Lactic acid is an independent risk factor for the prognosis of COVID-19.The combination of PII(first time),Lac and NLR may have a better clinical value.
基金项目
汕头市防治新型冠状病毒感染的肺炎专项(汕府科[2020]23号-1)
维普
万方数据