姚琳琳, 于宁, 刘保岩, 刘燕, 贺今. 尘肺合并新冠肺炎患者与普通新冠肺炎患者的临床特征及预后的差异性分析[J]. 环境与职业医学, 2024, 41(5): 574-578. DOI: 10.11836/JEOM23331
引用本文: 姚琳琳, 于宁, 刘保岩, 刘燕, 贺今. 尘肺合并新冠肺炎患者与普通新冠肺炎患者的临床特征及预后的差异性分析[J]. 环境与职业医学, 2024, 41(5): 574-578. DOI: 10.11836/JEOM23331
YAO Linlin, YU Ning, LIU Baoyan, LIU Yan, HE Jin. Difference of clinical characteristics and prognosis of COVID-19 complicated with or without pneumoconiosis in hospitalized patients[J]. Journal of Environmental and Occupational Medicine, 2024, 41(5): 574-578. DOI: 10.11836/JEOM23331
Citation: YAO Linlin, YU Ning, LIU Baoyan, LIU Yan, HE Jin. Difference of clinical characteristics and prognosis of COVID-19 complicated with or without pneumoconiosis in hospitalized patients[J]. Journal of Environmental and Occupational Medicine, 2024, 41(5): 574-578. DOI: 10.11836/JEOM23331

尘肺合并新冠肺炎患者与普通新冠肺炎患者的临床特征及预后的差异性分析

Difference of clinical characteristics and prognosis of COVID-19 complicated with or without pneumoconiosis in hospitalized patients

  • 摘要:
    背景 新型冠状病毒感染在全球广泛流行,更多的尘肺患者合并新型冠状病毒性肺炎。
    目的 探讨尘肺合并新冠肺炎患者与普通新冠肺炎患者在临床特征及预后方面的异同。
    方法 本研究分析了2022年12月10日至2022年12月31日在山东省职业病医院住院的36例新冠肺炎患者的临床特征和预后,包括尘肺合并新冠肺炎患者21例,无尘肺的普通新冠肺炎患者15例。观察对比两组患者的症状、体征、血常规等实验室检验结果、影像学表现、治疗方案及预后情况。
    结果 尘肺合并新冠肺炎患者与普通新冠肺炎患者症状、体征相比,呼吸困难(57.14% vs 0.00%)、肺部哮鸣音(28.57% vs 0.00%)、湿性啰音(76.19% vs 33.30%)、发热(61.90% vs 93.33%)差异有统计学意义(P<0.05)。与普通新冠肺炎组比较,尘肺合并新冠肺炎病例组D-二聚体水平增高2.340(1.0,6.5)mg·L−1 vs 0.250(0.2,0.4)mg·L−1P<0.01),血钠水平降低(138.10±2.68)mmol·L−1 vs(140.47±2.27)mmol·L−1P<0.05)。药物治疗及预后方面,尘肺合并新冠肺炎组与普通新冠肺炎组患者相比,使用抗病毒治疗(19.00% vs 80.00%)、糖皮质激素治疗(38.10% vs 80.00%)以及抗凝药物治疗(28.60% vs 0.00%),差异有统计学意义(P<0.05)。与普通新冠肺炎组比较,尘肺合并新冠肺炎病例组治愈率(90.50% vs 100.00%),差异无统计学意义。但尘肺合并新冠肺炎组存在2例死亡患者。
    结论 尘肺合并新冠肺炎患者出现发热更少,出现呼吸困难及哮鸣音、湿性啰音更多。血浆D-二聚体增高是尘肺合并新冠肺炎患者值得注意的指标。

     

    Abstract:
    Background The novel coronavirus infection is widespread in the world, resulting in more pneumoconiosis patients complicated with coronavirus disease 2019 (COVID-19).
    Objective To understand the clinical characteristics and prognosis of hospitalized COVID-19 patients complicated with or without pneumoconiosis.
    Methods A total of 36 COVID-19 patients admitted to the Shandong Provincial Occupational Disease Hospital from 10 December to 31 December 2022 were selected, including 21 cases in the complication group (pneumoconiosis complicated with COVID-19) and 15 cases in the COVID-19 group without pneumoconiosis. Symptoms, signs, laboratory test results(e.g. routine blood test), imaging findings, treatment plans and prognosis of the two groups were observed and compared.
    Results Regarding symptoms and signs in the complication group and the COVID-19 group, the proportions of dyspnea (57.14% vs 0.00%), lung wheezing (28.57% vs 0.00%), wet rales (76.19% vs 33.30%), and fever (61.90% vs 93.33%) were significantly different (P<0.05). Compared with the COVID-19 group, the level of D-dimer in the complication group was significantly increased 2.340 (1.0, 6.5) mg·L−1 vs 0.250 (0.2, 0.4) mg·L−1 (P<0.01), the serum sodium level was decreased (138.10±2.68) mmol·L−1 vs (140.47±2.27) mmol·L−1 (P<0.05). In terms of drug treatment and prognosis, there were statistically significant differences in the proportion of antiviral drugs (19.00% vs 80.00%), glucocorticoids (38.10% vs 80.00%), and anticoagulants (28.60% vs 0.00%) between the complication group and the COVID-19 group (P<0.05). Compared with the COVID-19 group, the cure rate of the complication group (90.50% vs 100.00%) showed no statistical difference. However, there were 2 deaths in the complication group.
    Conclusion Patients with pneumoconiosis complicated with COVID-19 have less fever and more dyspnea, wheezing, and wet rales. The increase of plasma D-dimer is a potential predictor in patients with pneumoconiosis complicated with COVID-19.

     

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