合并呼吸系统基础病的老年新型冠状病毒肺部感染患者临床及CT特征
Clinical and CT Imaging Characteristics of Elderly COVID-19 Patients with Underlying Respiratory Disease
李玲 1张明霞 1孙莹 1霍萌 1孙磊 1刘晓燕 2李兴鹏 1郝琪 1王仁贵1
作者信息
- 1. 首都医科大学附属北京世纪坛医院放射科,北京 100038
- 2. 首都医科大学附属北京世纪坛医院感染科,北京 100038
- 折叠
摘要
目的 探讨合并呼吸系统基础病的老年新型冠状病毒(COVID-19)肺部感染患者的临床及CT特征.资料与方法 回顾性纳入2022年12月首都医科大学附属北京世纪坛医院感染科72例老年COVID-19患者的临床、实验室及胸部CT资料,根据是否合并呼吸系统基础病(慢性支气管炎、肺气肿)分为合并呼吸系统基础病组 32 例及无呼吸系统基础病组 40 例,通过单因素分析两组临床及 CT 特征.结果 与无呼吸系统基础病组相比,合并呼吸系统基础病组患者初次就诊时存在喘憋占比更高(34.4%比12.5%;χ2=4.922,P=0.027)、C反应蛋白[40.6(19.9,67.8)mg/L比18.6(5.7,51.7)mg/L;Z=-2.119,P=0.034]及中性粒细胞百分比更高[73.4(64.3,80.6)%比 67.5(61.7,73.8)%;Z=-1.961,P=0.049];CT显示,合并基础病患者纵隔增大淋巴结数目更多[2.0(1.0,3.0)个比1.0(0,2.0)个;χ2=-2.042,P=0.041],存在蜂窝影(21.9%比0,P=0.002)、结节状(78.1%比51.3%;χ2=5.457,P=0.019)、大片状(81.3%比50.0%;χ2=7.525,P=0.006)及束带状(59.4%比30.0%;χ2=6.257,P=0.012)形态的比例更高,同时存在小气道壁增厚(100.0%比82.5%,P=0.015)、牵拉性支气管扩张(93.8%比57.5%;χ2=12.026,P=0.001)、纤维索条(90.6%比62.5%;χ2=7.500,P=0.006)及铺路石征(78.1%比45.0%;χ2=8.109,P=0.004)的比例更高.结论 合并呼吸系统基础病的老年COVID-19患者临床及CT征象均存在一定特征,可为临床早期诊断及治疗提供相应指导.
Abstract
Purpose To investigate the clinical and CT imaging characteristics of elderly patients with coronavirus disease 19(COVID-19)combined with underlying respiratory disease.Materials and Methods The clinical,laboratory and chest CT imaging data of elderly COVID-19 patients admitted to the Department of Infectious Diseases of Beijing Shijitan Hospital of Capital Medical University in December 2022 were retrospectively included,72 elderly patients with COVID-19 were enrolled.The patients were divided into two groups according to whether they had underlying respiratory diseases(chronic bronchitis,emphysema),including 32 patients combined with underlying respiratory disease and 40 patients without underlying respiratory disease.The clinical and CT features of the two groups were analyzed.Results Compared with the group without underlying respiratory disease,higher percentage of elderly COVID-19 patients in the combined underlying respiratory disease group had dyspnea at the initial visit(34.4%vs.12.5%;χ2=4.922,P=0.027),C-reactive protein[40.6(19.9,67.8)mg/L vs.18.6(5.7,51.7)mg/L;Z=-2.119,P=0.034]and neutrophil percentage[73.4(64.3,80.6)%vs.67.5(61.7,73.8)%;Z=-1.961,P=0.049].In terms of CT imaging parameters,patients with underlying disease had more enlarged mediastinal lymph nodes[2.0(1.0,3.0)vs.1.0(0,2.0);χ2=-2.042,P=0.041].There was a higher proportion of honeycomb sign(21.9%vs.0,P=0.002),nodular(78.1%vs.51.3%;χ2=5.457,P=0.019),large patchy(81.3%vs.50.0%;χ2=7.525,P=0.006)and banded patterns(59.4%vs.30.0%;χ2=6.257;P=0.012).At the same time,the proportion of small airway wall thickening(100.0%vs.82.5%,P=0.015),branch dilatation(93.8%vs.57.5%;χ2=12.026,P=0.001),fibrous cable(90.6%vs.62.5%;χ2=7.500,P=0.006)and crazy-paving pattern(78.1%vs.45.0%;χ2=8.109,P=0.004)were higher.Conclusion In elderly COVID-19 patients with underlying respiratory disease,there are certain characteristics of clinical and CT imaging signs,which can provide guidance for early clinical diagnosis and treatment.
关键词
2019冠状病毒性疾病/多层螺旋计算机体层摄影术/肺疾病/老年人Key words
COVID-19/Multidetector computed tomography/Lung diseases/Aged引用本文复制引用
出版年
2024
NETL
NSTL
万方数据