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  • 戈霞晖,许靖,哈明昊,张丽葳,宋黎涛,王杰宁,林研,高晓燕,白冲.新型冠状病毒肺炎患者6例临床特征和影像学表现[J].第二军医大学学报,2020,41(6):616-620    [点击复制]
  • GE Xia-hui,XU Jing,HA Ming-hao,ZHANG Li-wei,SONG Li-tao,WANG Jie-ning,LIN Yan,GAO Xiao-yan,BAI Chong.Clinical features and imaging findings in six coronavirus disease 2019 patients[J].Acad J Sec Mil Med Univ,2020,41(6):616-620   [点击复制]
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新型冠状病毒肺炎患者6例临床特征和影像学表现
戈霞晖1,许靖1,哈明昊2,张丽葳3,宋黎涛4,王杰宁5,林研5,高晓燕5,白冲6*
0
(1. 上海中医药大学附属第七人民医院呼吸科, 上海 200137;
2. 上海中医药大学附属第七人民医院感染科, 上海 200137;
3. 上海中医药大学附属第七人民医院急诊科, 上海 200137;
4. 上海中医药大学附属第七人民医院放射科, 上海 200137;
5. 上海中医药大学附属第七人民医院院长办公室, 上海 200137;
6. 海军军医大学(第二军医大学)长海医院呼吸与危重症医学科, 上海 200433
*通信作者)
摘要:
目的 总结6例新型冠状病毒肺炎(COVID-19)患者的临床特征和影像学表现,为COVID-19早期确诊和临床干预提供依据。方法 选择上海中医药大学附属第七人民医院2020年1月1日至2020年2月22日严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸检测阳性的6例COVID-19患者,回顾性分析流行病学史、临床表现、影像学资料和实验室检查。结果 6例患者均有明确的武汉旅行或居住史,4例患者有发热,3例有咳嗽,2例有流涕、咽痛等上呼吸道症状,2例有头痛、肌肉酸痛等全身症状。6例患者胸部CT检查均可见肺部异常表现,病灶均为双侧分布,下肺病灶多于上肺,主要表现为双侧肺野外带多发磨玻璃影、实变影、“铺路石”征及不同程度纤维化。发病后较晚行胸部CT检查可见肺实变和明显纤维化。结论 COVID-19影像学具有一定的特征性表现,结合患者流行病学史、临床表现和SARS-CoV-2核酸检测能早期诊断。
关键词:  新型冠状病毒肺炎|临床特征|X线计算机体层摄影术|鉴别诊断
DOI:10.16781/j.0258-879x.2020.06.0616
投稿时间:2020-03-02修订日期:2020-04-28
基金项目:上海市浦东新区卫生健康委员会联合攻关项目(PW2019D-3).
Clinical features and imaging findings in six coronavirus disease 2019 patients
GE Xia-hui1,XU Jing1,HA Ming-hao2,ZHANG Li-wei3,SONG Li-tao4,WANG Jie-ning5,LIN Yan5,GAO Xiao-yan5,BAI Chong6*
(1. Department of Respiratory Medicine, The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
2. Department of Infectious Diseases, The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
3. Department of Emergency Medicine, The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
4. Department of Radiology, The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
5. President's Office, The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
6. Department of Respiratory and Critical Care Medicine, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To summarize the clinical features and imaging findings of six coronavirus disease 2019 (COVID-19) patients, so as to provide evidences for early diagnosis and clinical intervention. Methods Six COVID-19 patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were enrolled from the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from Jan. 1 to Feb. 22, 2020. The epidemiological history, clinical manifestations, imaging data and laboratory indicators were retrospectively analyzed. Results All six patients had a clear travel or residence history in Wuhan. Four patients had fever, three had cough, two had upper respiratory tract symptoms such as runny nose and sore throat, and two had systemic symptoms such as headache and muscle ache. Chest computed tomography (CT) showed that all the six patients had abnormal manifestations in bilateral lungs, and the lower lung lesions were more common than the upper lung lesions. The main manifestations were multiple ground-glass opacities, consolidation shadows, "crazy paving" sign and different degrees of fibrosis in lateral field of bilateral lungs. Chest CT examination later after onset showed lung consolidation and severe fibrosis. Conclusion The imaging of COVID-19 has special characteristics. Combined with the epidemiological history, clinical manifestations and the detection of SARS-CoV-2 nucleic acid, COVID-19 can be effectively diagnosed in the early stage.
Key words:  coronavirus disease 2019|clinical characteristics|X-ray computed tomography|differential diagnosis