庄晓旭

摘要：目的：研究分析疑似及確诊新冠肺炎患者临床及胸部CT影像特点。方法：研究对象为我院2020年1月-2020年12月收治的30例疑似及确诊新冠肺炎患者。其中与《新型冠状病毒肺炎影像诊断指南（2020年第二版简版）》中规定的新冠肺炎诊断标准相符合，但2次以上核酸检测结果为阴性的疑似患者共21例为对照组，同时与以上新冠肺炎诊断标准相符合且核酸检测结果为阳性的确诊患者共9例为研究组。所有患者入院时均进行实验室检查及胸部CT检查，以白细胞数、淋巴细胞百分比、肌酸激酶、丙氨酸转氨酶、天冬氨酸转氨酶、高敏C反应蛋白、红细胞沉降率及病灶密度、形态、病灶分布、间质增厚、病灶内血管束增粗、条索灶、胸腔积液为观察指标。结果：研究组白细胞数、淋巴细胞百分比、肌酸激酶、红细胞沉降率与对照组相比均有显著差异（P<0.05），而丙氨酸转氨酶、天冬氨酸转氨酶、高敏C反应蛋白均无显著差异（P>0.05）;研究组患者病灶CT影像密度、形态、病灶分布、间质增厚、病灶内血管束增粗、条索灶、胸腔积液与对照组相比均有显著差异（P<0.05）。结论：在白细胞数、淋巴细胞百分比、肌酸激酶、红细胞沉降率及密度、形态、病灶分布、间质增厚、病灶内血管束增粗、条索灶、胸腔积液等方面确诊新冠肺炎患者与疑似新冠肺炎患者存在显著差异，临床上应予以重视，从而更加准确地鉴别新冠肺炎。

关键词：新冠肺炎;疑似;确诊;临床;胸部CT影像

中图分类号：R445文献标识码：BDOI：10？郾3969/j.issn.1001-0270.2021.03.11

Abstract： Objective： To study and analyze the clinical and chest CT imaging characteristics of patients with suspected and confirmed new coronary pneumonia. Methods： The subjects of the study were 30 patients with suspected and confirmed new coronary pneumonia admitted to our hospital from January 2020 to December 2020. Among them， 21 suspected patients who met the diagnostic criteria for new coronary pneumonia stipulated in the New Coronavirus Pneumonia Imaging Diagnosis Guide （Second Edition 2020 Simplified Edition） but whose nucleic acid test results were negative for more than 2 times served as the control group. A total of 9 confirmed patients who meet the above new coronary pneumonia diagnostic criteria and have a positive nucleic acid test result are the study group Laboratory examinations and chest CT examinations were performed on all patients when they were admitted to the hospital. The number of white blood cells， the percentage of lymphocytes， creatine kinase， alanine aminotransferase， aspartate aminotransferase， high-sensitivity C-reactive protein， erythrocyte sedimentation rate and lesion density and morphology were performed. ， Lesion distribution， interstitial thickening， thickening of vascular bundles within the lesion， cord focus， and pleural effusion are the observation indicators. Results： The number of white blood cells， percentage of lymphocytes， creatine kinase， and erythrocyte sedimentation rate in the study group were significantly different from those in the control group （P<0.05）， while alanine aminotransferase， aspartate aminotransferase， and high-sensitivity C-reactive protein were all significantly different from those in the control group. No significant difference （P>0.05）; the CT image density， morphology， lesion distribution， interstitial thickening， thickening of vascular bundles in the lesions， striae lesions， and pleural effusion in the study group were significantly different from those in the control group （P<0.05）. Conclusion： The number of white blood cells， the percentage of lymphocytes， creatine kinase， erythrocyte sedimentation rate and density， morphology， lesion distribution， interstitial thickening， thickening of vascular bundles within the lesion， striae， pleural effusion， etc.， are diagnosed in patients with new coronary pneumonia There are significant differences from patients with suspected new coronary pneumonia， and clinical attention should be paid to more accurately identify new coronary pneumonia.

Key Words： new coronary pneumonia; suspected; confirmed; clinical; chest CT imaging

2020年初于我国武汉发现的新型冠状病毒肺炎（以下简称“新冠肺炎”）迅速在国内蔓延。该疾病可通过肢体接触及呼吸道飞沫进行传播，具有较强的传染性，对广大人民群众的身体健康及生命安全造成了极大的威胁。疫情爆发初期，临床上主要通过RT-PCR试剂盒进行核酸检测排查感染者，但是随着该方法的广泛应用其不足之处也逐渐暴露出来，主要表现为采集方式受限、假阳性较高等问题[1-2]。……