结核与肺部疾病杂志 ›› 2020, Vol. 1 ›› Issue (2): 126-130.doi: 10.3969/j.issn.2096-8493.2020.02.007

• 论著 • 上一篇    下一篇

新型冠状病毒肺炎患者肺部CT病变质量及外周血淋巴细胞计数的动态演变分析

沈聪*, 焦磊, 白璐, 张毅力, 郭佑民()   

  1. 710061 西安交通大学第一附属医院影像科(沈聪、白璐、张毅力、郭佑民);陕西省渭南市中心医院影像科(焦磊)
  • 收稿日期:2020-06-15 出版日期:2020-09-30 发布日期:2020-10-15
  • 通信作者: 沈聪,郭佑民 E-mail:cjr.guoyoumin@vip.163.com
  • 基金资助:
    中华人民共和国国家卫生和健康委员会公益性行业科研专项基金(201402013)

Analysis of the dynamic evolution of Chest CT lesions quality and peripheral blood lymphocyte count in patients with coronavirus disease 2019

SHEN Cong*, JIAO Lei, BAI Lu, ZHANG Yi-li, GUO You-min()   

  1. *Department of Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061,China
  • Received:2020-06-15 Online:2020-09-30 Published:2020-10-15
  • Contact: SHEN Cong,GUO You-min E-mail:cjr.guoyoumin@vip.163.com

摘要:

目的 动态分析新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)患者CT表现及淋巴细胞计数演变的一致性与不一致性。方法 回顾性收集2019年1月28日至2020年4月11日在我院经核酸检测确诊为新型冠状病毒肺炎的患者17例,均为普通型。收集首次及随访的CT检查(共110次)和外周血的淋巴细胞计数(lymphocyte count, LC)(共145次)。使用计算机自动分割病变,计算病变质量(lesion quality, LQ)。将每例患者的LC和LQ除以该患者整个病程中的最大值,使其标准化至[0,1]区间内。以患者出现首个症状为第1天,绘制出每例患者LC和LQ的动态变化,使用移动加权平均法拟合二者的变化趋势,分析影像学与淋巴细胞变化的一致性和不一致性。结果 绘制出每一例患者的LC和LQ的变化图。使用移动加权平均法拟合,计算得出LC的最低值在(5.294±3.820)d(第1~12天),LQ的峰值在(9.589±3.203)d(第5~16天),二者差异有统计学意义(t=7.170,P<0.05);LC恢复至正常水平的中位天数为19d(15~42d)。在病程的第1~5天,病变进展快速,LC下降,LQ快速上升;第6~10天,病变进展减慢,LC开始恢复,LQ上升速度减慢;第11~22天,LC持续上升至正常水平,LQ快速下降,二者呈明显的负相关(r=-0.764, P=0.002);超过22d,LC接近或维持正常水平,LQ维持于较低水平。结论 COVID-19患者LC降低早于CT上LQ的最大值。

关键词: 新型冠状病毒肺炎, 体层摄影术,X线计算机, 病变质量, 淋巴细胞计数, 数据说明, 统计

Abstract:

Objective To comprehensively analyze the consistency and inconsistency of CT manifestations of lung lesions and the dynamic evolution of lymphocyte count in patients with new coronavirus pneumonia (coronavirus disease 2019, COVID-19). Methods A retrospective collection of 17 patients who were diagnosed with novel coronavirus pneumonia by nucleic acid testing in our hospital from January 28, 2019 to April 11, 2020, all of them were of ordinary type. Collect the first and follow-up CT examinations (110 times in total) and the lymphocyte count (LC) of peripheral blood (145 times in total). Use a computer to automatically segment the lesion and calculate the lesion quality (LQ). The LC and LQ of each patient were divided by the maximum value in the entire course of the patient, and standardized to the interval (0,1). Taking the patient’s first symptom as the first day, the dynamic changes of LC and LQ of each patient were drawn, and the moving weighted average method was used to fit the change trend, and the consistency and inconsistency of imaging and lymphocyte changes were described. Results The changes in LC and LQ of each patient were plotted. Using the moving weighted average method to fit, the lowest value of LC was calculated at (5.294±3.820) days (days 1-12), and the peak of LQ was at (9.589±3.203) days (days 5-16). There was a significant difference between the two (t=7.170, P<0.05); the median number of days for LC to returning to normal level was 19 days (15 to 42 days). On the 1st to 5th days of the disease course, the lesion progresses rapidly, LC decreases, and LQ rises rapidly; on the 6th to 10th days, the lesion progresses slowly, and LC begins to recover, and LQ slows down; on the 11th to 22nd days, LC continues to rise to the normal level, LQ declined rapidly, and there was a significant negative correlation between the two (r=-0.764, P=0.002); after 22 days, LC was close to or maintained at a normal level, and LQ remains at a low level. Conclusion The lymphocyte count of patients with novel coronary pneumonia decreased earlier than the maximum lesion area.

Key words: Coronavirus disease 2019 (COVID-19), Tomography,X-ray computer, Lesion quality, Lymphocyte count, Data interpretation, statistical