新型冠状病毒肺炎的HRCT表现、PII与临床的相关性研究

High resolution CT manefestation and pulmonary inflammation index of COVID-19 as well as their clinical correlation

摘要:

目的：分析新型冠状病毒肺炎（coronavirus disease 2019，COVID-19），的高分辨率CT（high resolution CT，HRCT）影像表现，探讨CT肺部炎症指数（pulmonary inflammation index，PII）和临床多项实验室指标的相关性。方法：回顾性分析重庆医科大学附属永川医院2020年1至2月感染专科病房收治的57例COVID-19患者肺部HRCT影像表现，计算PII，分析PII与年龄、细胞沉降率（erythrocyte sedimentation tate，ESR）、C反应蛋白（C-reactive protein，CRP）、白介素-6（interleukin-6，IL-6）、淋巴细胞计数（lymphocyte，LYM）及氧合指数（oxygenation index，OI）的相关性。结果：肺部阴性者3例，阳性病变54例。HRCT表现早期8例，进展期45例，转归期1例，合并双侧少量胸腔积液1例、支气管扩张1例、继发性肺结核3例、主动脉壁或（及）心脏冠状动脉壁钙化7例、肺气肿5例。PII与年龄、ESR、CRP、IL-6呈正相关（P＜0.05）；PII与LYM、OI呈负相关性（P＜0.05）。结论：COVID-19的HRCT表现具有一定特征性，PII和临床多个实验室指标均具有相关性，可作为半定量评估COVID-19肺部损伤的手段之一。

Abstract:

Objective：To analyze the high resolution CT（HRCT） imaging manifestations of coronavirus disease 2019（COVID-19） and to investigate the correlation between CT pulmonary inflammation index（PII） and multiple clinical laboratory indexes. Methods： HRCT imaging of 57 patients with COVID-19 admitted to our hospital from January 2020 to February 2020 in our hospital were retrospectively analyzed，CT pulmonary inflammation index was calculated，and the correlation of CT pulmonary inflammation index with patients’ age，erythrocyte sedimentation tate（ESR），C-reactive protein（CRP），interleukin 6（IL-6），lymphocyte count（LYM） and oxygenation index（OI） was analyzed. Results：There were 3 patients with negative pulmonary examination and 54 patients with posi－tive lung lesions. HRCT showed 8 patients in early stage，45 patients in advanced stage，1 patient in remission stage，1 patient with bilateral small amount of pleural effusion，1 patient with bronchiectasis，3 patients with tuberculosis，7 patients with calcification of aortic wall or（and） coronary artery wall，and 5 patients with emphysema. CT PPI was positively correlated with age，ESR，CRP and IL-6（P<0.05）；was negatively correlated with Lym and OI（P<0.05）. Conclusion：HRCT manifestations of COVID-19 have certain characteristics. CT PPI is correlated with multiple clinical laboratory indexes，and can be used as a means of semi-quantitative assessment of COVID-19 lung injury.