2021 年第 5 期 第 16 卷

新型冠状病毒肺炎合并2型糖尿病患者的临床特征及预后分析

Clinical characteristics and prognosis of patients with corona virus disease-19 and type 2 diabetes mellitus

作者：施金枝戴锴张倩杨凡陈晓蓓

英文作者：Shi Jinzhi Dai Kai Zhang Qian Yang Fan Chen Xiaobei

单位：武汉大学人民医院感染科430060

英文单位：Department of Infectious Diseases Renmin Hospital of Wuhan University Wuhan 430060 China

关键词：新型冠状病毒肺炎；2型糖尿病；临床特征

英文关键词：Coronavirusdisease-19;Type2diabetesmellitus;Clinicalcharacteristics

• 摘要：

• 目的 探讨新型冠状病毒肺炎（COVID-19）合并2型糖尿病患者的临床特征及预后。方法 收集武汉大学人民医院东院区2020年2月1日至2020年3月10日收治的76例COVID-19合并2型糖尿病患者的临床资料。总结患者的临床特征及预后。结果 76例患者中，男、女各占50.0%，平均年龄为（68±10）岁，普通型15例（19.7%）、重型37例（48.7%）、危重型24例（31.6%）。临床表现主要为发热（64例，84.2%）、干咳（50例，65.8%）和乏力（51例，67.1%）等。与普通型和重型患者比较，危重型患者的白细胞计数、中性粒细胞计数、天冬氨酸转氨酶、血尿素氮、血糖、乳酸脱氢酶、C反应蛋白>10 mg/L者比例、D-二聚体、N末端B型脑钠肽前体、肌酸激酶同工酶、肌红蛋白、高敏心肌肌钙蛋白I（hs-cTnI）>0.04 μg/L者比例均高，而淋巴细胞计数、血小板计数、白蛋白水平、CD3、CD4、CD8细胞计数均低（均P<0.05)。76 例患者中，出现呼吸衰竭26例(34.2%)、急性心肌损伤9例(11.8%)、休克6例(7.9%)、肾衰竭3例(3.9%)；好转出院55例(72.4%)、死亡21例(27.6%)，死亡者均为危重型患者，3组患者的病死率差异有统计学意义(P<0.05)。结论 COVID-19合并2型糖尿病患者的病死率相对较高，其中危重型患者更容易出现多器官功能损害，预后更差。

• Objective To investigate the clinical characteristics and prognosis of patients with corona virus disease-19(COVID-19) and type 2 diabetes mellitus. Methods The clinical data of 76 diabetic cases with COVID-19 in East District of Renmin Hospital of Wuhan University from February 1 to March 10, 2020 were collected. The clinical characteristics and prognosis were summarized. Results Among 76 cases, male and  females accounted for 50.0% and 50.0%, respectively, with an average age of (68±10) years. There were 15 cases of ordinary type(19.7%), 37 cases of severe type(48.7%) and 24 cases of critical type(31.6%). The main clinical manifestations were fever(64 cases, 84.2%), dry cough(50 cases, 65.8%), weakness(51 cases, 67.1%) and so on. Compared with the patients in ordinary type and severe type, white blood cell count, neutrophil count, aspartate transaminase, blood urea nitrogen, blood glucose, lactate dehydrogenase, ratio of C-reactive protein>10 mg/L, D-dimer, N terminal pro-brain natriuretic peptide, creatine kinase isoenzymes, myoglobin, ratio of high-sensitivity cardiac troponin I(hs-cTnI) >0.04 μg/L in critical type were higher; while the lymphocyte count, platelet count, albumin level, and the counts of CD3, CD4 and CD8 cells in critical type were lower (all P<0.05). Among the 76 cases, 26 cases(34.2%) had respiratory failure, 9 cases(11.8%) had acute myocardial injury, 6 cases(7.9%) had shock and 3 cases(3.9%) had renal failure. There were 55 cases (72.4%) discharged after improvement, and 21 cases (27.6%) died, all of the death cases were in the critical type. There was a significant difference in mortality among the patients of three types(P<0.05). Conclusions The mortality of type 2 diabetes mellitus patients with COVID-19 is relatively high. Critical patients are more likely to have multiple organ dysfunction and poor prognosis.