开放期刊系统

2021甘肃兰州地区新型冠状病毒Delta临床及胸部CT表现和病理基础

敬春 王

摘要

目的 研究2021甘肃省兰州地区新型冠状病毒Delta的临床表现及胸部CT表现。方法 对137例新型冠状病毒Delta临床表现及胸部CT扫描表现进行回顾性分析。结果 主要临床表现为咽痛70例(51.1%)、咳嗽58例(42.3 %)、发热27例(19.7%)、咳痰25例(18.2%)、无症状29例(21.2 %);实验室检查外周血C-反应蛋白增高61(44.5%)、外周血白细胞计数正常108例(78.8 %)、降低28例(20.4%)、升高1例(0.7%),淋巴细胞计数正常134例(97.8 %),降低4例(2.9%);CT表现单侧或双肺多发磨玻璃影单肺23例(16.8%),双肺42例(30.6 %);结论 2021年甘肃兰州地区新型冠状病毒Delta变异株临床表现主要表现为咽痛、咳嗽、发热;胸部CT表现一侧肺叶或双肺上叶尖后段及下叶后基底段胸膜下多发磨玻璃影、大部分实变影及血管增粗症; 新型冠状病毒肺炎病理致病机制是一个十分复杂的过程,涉及病毒的侵入与复制、传播,多系统、多器官的受累等多方面因素,需结合科学技术的进步,多中心、大样本进一步长期随访研究,才能开发出更有效的治疗方法和预防策略,以应对这一全球性的公共卫生挑战。

关键词

2021年 ; 甘肃省 ; 新型冠状病毒肺炎 ; Delta ;胸部CT ; 病理


参考

参考文献

国家卫生健康委员会,国家中医药管理局.新型冠状病毒感染的肺炎诊疗方案(试行第十版).[EB/OL].[2023-01-06].http://www.Nhc.gov.cn/yzygj/.

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, Si HR, Zhu Y, Li B, Huang CL, Chen HD, Chen J, Luo Y, Guo H, Jiang RD, Liu MQ, Chen Y, Shen XR, Wang X, Zheng XS, Zhao K, Chen QJ, Deng F, Liu LL, Yan B, Zhan FX, Wang YY, Xiao GF, Shi ZL (2020) A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 579:270–273.

Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA, Somasundaran M, Sullivan JL, Luzuriaga K, Greenough TC, Choe H, Farzan M (2003) Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature 426:450-454.

Ye ZW, Yuan S, Yuen KS, Fung SY, Chan CP, Jin DY. Zoonotic origins of human coronaviruses. Int J Biol Sci. 2020;16:1686-97.

Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh C-L, Abiona O, Graham BS, McLellan JS (2020) Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 367:1260.

Xu J, Xu X, Jiang L, Dua K, Hansbro PM, Liu G (2020) SARSCoV-2 induces transcriptional signatures in human lung epithelial cells that promote lung fibrosis. Respiratory Research 21:182.

Hoffmann M,Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu N-H, Nitsche A,Müller MA, Drosten C, Pöhlmann S (2020) SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 181:271–280.

Karmouty-Quintana H, Thandavarayan RA, Keller SP, Sahay S, Pandit LM, Akkanti B (2020) Emerging mechanisms of pulmonary vasoconstriction in SARS-CoV-2-induced acute respiratory distress syndrome (ARDS) and potential therapeutic targets. Int J Mol Sci 21(21):E8081.

Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR, Barr RG, Chang BP, Chau KH, Choi JJ, Gavin N, Goyal P, Mills AM, Patel AA, Romney M-LS, Safford MM, Schluger NW, Sengupta S, Sobieszczyk ME, Zucker JE, Asadourian PA, Bell FM, Boyd R, Cohen MF, Colquhoun MI, Colville LA, de Jonge JH, Dershowitz LB, Dey SA, EisemanKA, Girvin ZP, Goni DT, Harb AA, Herzik N, Householder S, Karaaslan LE, Lee H, Lieberman E, Ling A, Lu R, Shou AY, Sisti AC, Snow ZE, Sperring CP, Xiong Y, Zhou HW, Natarajan K, Hripcsak G, Chen R (2020) Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ 369:m1996.

Li Y, Xu Q, Ma L, Wu D, Gao J, Chen G, Li H (2020) Systematic profiling ofACE2. expression in diverse physiological and pathological conditions for COVID-19/SARS-CoV-2. Journal of Cellular and Molecular Medicine 24:9478-9482.

陈莉,杨先春,李小兵.普通型新型冠状病毒肺炎的早期影像学表现(附24例分析) [J].中国CT和MRI杂志,2022,(2):48-50,86.

刘雪艳,唐光孝,李春华,等.重症新型冠状病毒肺炎患者胸部计算机断层成像表现 及动态变化分析[J].中华传染病杂志,2020,38(03):155-158.

Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F,Vanstapel A, Werlein C, Stark H, Tzankov A, Li WW, Li VW, Mentzer SJ, Jonigk D (2020) Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. New England Journal ofMedicine 383:120–128.

Li L,Qin L,Xu Z, Yin Y, Wang X, Kong B, Bai J, Lu Y, Fang Z, Song Q, Cao K, Liu D, Wang G, Xu Q, Fang X, Zhang S, Xia J, Xia J (2020) Artificial intelligence distinguishes COVID-19 from community acquired pneumonia on chest CT. Radiology 296: E65–E71.

Vardavas CI, Nikitara K (2020) COVID-19 and smoking: a systematic review of the evidence. Tobacco Induced Diseases 18:20 62. Pinto BGG, Oliveira AER, Singh Y, Jimenez L, Goncalves ANA.

Higham A, Singh D (2020) Increased ACE2 expression in the bronchial epithelium of COPD patients who are overweight.Obesity 28:1586–1589.

Brake SJ, Barnsley K, Lu W, McAlinden KD, Eapen MS, Sohal SS (2020) Smoking upregulates angiotensin-converting enzyme-2 receptor: a potential adhesion site for novel coronavirus SARSCoV-2 (COVID-19).Journal of Clinical Medicine 9:841.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, DavidsonKW, Consortium and the NC-19 R (2020) Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 323:2052-2059.

Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, Quaderi S, Mandal S, Hurst JR (2020) Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. PLOS ONE 15:e0233147.

X. Xu, et al., Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission, Sci China Life Sci 63(3) (2020),457–460.

Disease Prevention and Control Bureau of the National Health Commission. Prevention and control plan for novel coronavirus pneumonia (Version II) (2020),1-22.

Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology.2020;296:E41-E45.

向容,刘翔雏,吴勇.新型冠状病毒肺炎的CT表现[J].中国CT和MRI杂 志,2022,(7):70-72.

Fang Y,Zhang H,Xie J,Lin M,Ying L et al.Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020: 200432.

Chung M,Bernheim A, Mei X,Zhang N, Huang M et al.CT imaging features of 2019 novel coronavirus (2019- nCoV). Radiology 2020; 295(1): 202-207. doi: 10.1148/ radiol.2020200230.

Xiong Y,Sun D,Liu Y,et al.Clinical and High-Resolution CT Features of the COVID-19 Infection:of the Initial and Follow-up Changes[J].Invest Radiol.2020,55(6):332-339.

Salehi S,Abedi A,Balakrishnan S,et al.Coronavirus Disease 2019 (COVID19):A Systematic Review of Imaging Findings in 919 Patients[J].AJR Am J Roentgenol.2020,215(l):87-93.

Xiong Y, Sun D, Liu Y, Fan Y, Zhao L et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Investigative Radiology 2020; 10.1097.

Chung M,Bernheim A,Mei X,etal.CT imaging features of 2019novel coronavirus (2019-nCoV) [J].Radiology,2020,295,(1):202-207.

Han R,Huang L,Dong J,etal.Early Clinical and CT Manifestationgs of Coronnavirus Disease 2019 (COVID -19) Pneumonia[J].AJR Am JRoentgenol,2020,215(2):338-343.

Refbacks

  • 当前没有refback。