文章摘要
刘 燕,幸奠霞,黄 鸿,邓 静,王 霞,覃燕华,张 一,吴小婷,范仕兵,傅国平.新型冠状病毒肺炎患者血小板减少的临床意义及影响因素分析[J].,2020,(17):3384-3387
新型冠状病毒肺炎患者血小板减少的临床意义及影响因素分析
Analysis of the Clinical Significance and Influencing Factors for Thrombocytopenia with COVID-19
投稿时间:2020-04-08  修订日期:2020-04-30
DOI:10.13241/j.cnki.pmb.2020.17.042
中文关键词: 新型冠状病毒肺炎  血小板减少  临床意义  影响因素
英文关键词: Novel corona virus disease 2019  Thrombocytopenia  Clinical significance  Influencing factors
基金项目:中央高校基本科研业务费资助项目(NO2020CDJYGRH-YJ03)
作者单位E-mail
刘 燕 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000 lyliuyan1985@163.com 
幸奠霞 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
黄 鸿 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
邓 静 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
王 霞 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
覃燕华 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
张 一 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
吴小婷 重庆大学附属三峡医院/重庆三峡中心医院老年医学科 重庆 404000  
范仕兵 重庆大学附属三峡医院/重庆三峡中心医院神经外科 重庆 404000  
傅国平 重庆大学附属三峡医院/重庆三峡中心医院呼吸内科 重庆 404000  
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中文摘要:
      摘要 目的:分析新型冠状病毒肺炎(COVID-19)患者临床特征,研究血小板减少在COVID-19中的发生率及临床意义,并探讨血小板减少的相关危险因素。方法:回顾性分析我院2020年1月24日至2020年3月9日收治的47例COVID-19患者,发生血小板减少的患者记为实验组(27例),血小板正常的患者记为对照组(20例),记录患者一般临床资料及入院后各实验室检测指标,分析血小板减少的临床意义及影响因素。结果:入组患者中血小板减少发生率为57.45%。两组患者中白细胞计数、中性粒细胞比率、白蛋白、肌酐、白细胞介素6(IL-6)比较差异无统计学意义(P>0.05),血小板计数、最低血小板计数、D二聚体最高值、降钙素原、CD4+T淋巴细胞计数、肿瘤坏死因子-α(TNF-α)比较差异有统计学意义(P<0.05),实验组患者死亡率、危重症比例、呼吸机使用比例、多器官功能衰竭比例、住院费用较对照组明显增多(P<0.05)。二元 Logistic回归分析显示D二聚体、CD4+T淋巴细胞计数、TNF-α是引起血小板减少的影响因素(P<0.05)。结论:COVID-19患者的血小板减少发生率高,且血小板减少提示患者病情重,预后差,D二聚体、CD4+T淋巴细胞计数、TNF-α是引起血小板减少的影响因素。
英文摘要:
      ABSTRACT Objective: To analyze the clinical characteristics with novel corona virus disease 2019 (COVID-19), to investigate the incidence and clinical significance of thrombocytopenia with COVID-19 and to explore the related risk factors of thrombocytopenia. Methods: A retrospective analysis of 47 patients with COVID-19 who were admitted to our hospital from January 24, 2020 to March 9, 2020.The patients with thrombocytopenia were recorded as the experimental group (27 cases), and patients with normal platelet were recorded as control group (20 cases). The general clinical data and laboratory test indexes after admission were recorded. The clinical significance and influencing factors of thrombocytopenia were analyzed. Results: Thrombocytopenia occurred in 57.45% of enrolled patients. There were no significant difference in leukocyte count, neutrophil ratio, albumin, creatinine and interleukin 6 (IL-6) between the two groups (P>0.05). The differences in platelet count, lowest platelet count, highest D-dimer, calcitonin, CD4+T lymphocyte count, and tumor necrosis factor-α(TNF-α) were statistically significant(P<0.05). The mortality rate, critical illness rate, ventilator use rate, multi-organ failure rate and hospitalization expenses of the experimental group were significantly higher than those of the control group(P<0.05). Binary Logistic regression analysis showed that D dimer, CD4+T lymphocyte count and TNF-α were influential factors for thrombocytopenia (P<0.05). Conclusion: The incidence of thrombocytopenia in COVID-19 is high, and thrombocytopenia indicated that the patient are seriously ill, and which has a poor prognosis. D-dimer, CD4+T lymphocyte count and TNF-α are the influencing factors for thrombocytopenia.
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