摘要
目的:探讨血钙水平与新型冠状病毒肺炎(COVID-19)严重程度的相关性。方法:回顾性分析2020年1至2月河南省人民医院、郑州市第六人民医院及周口市传染病医院确诊的165例COVID-19患者的临床数据。结合临床分型,比较危重症组与对照组患者间各种指标差异,采用多因素 logistic回归分析疾病严重程度影响因素。根据校正后血清总钙水平分为低血钙组与正常血钙组,比较两组相关指标进一步分析低钙血症发病原因。 结果:与对照组相比,危重症组年龄、糖尿病、基础呼吸疾病及心血管疾病占比、C反应蛋白(CRP)、空腹血浆血糖(FPG)、干扰素γ(IFN-γ)、白细胞介素17(IL-17)水平升高,淋巴细胞百分比、血清白蛋白(ALB)、校正后血钙、CD4 +T细胞%、CD8 +T细胞%水平降低,差异具有统计学差异( P<0.05),两组间性别、高血压病占比、丙氨酸氨基转移酶(ALT)、肾小球滤过率(eGFR)、CD4 +/CD8 +比值、白细胞介素4(IL-4)水平无明显统计学差异( P>0.05)。校正后血钙水平下降、年龄及eGFR升高均为COVID-19患者罹患重症的危险因素。与正常血钙组相比,低血钙组ALB、CD4 +T细胞百分比、CD8 +T细胞百分比水平降低,年龄、危重症比例、合并糖尿病、呼吸系统及心血管疾病比例、CRP水平升高,差异具有统计学意义( P<0.05),余无统计学差异( P>0.05)。 结论:COVID-19危重症患者存在明显低钙血症和免疫功能失调,密切监测血钙水平可以更有效地预测疾病严重程度。
Objective To investigate the correlation between serum calcium levels and severity of novel coronavirus pneumonia(COVID-19).Methods The clinical data of 165 COVID-19 patients diagnosed from January to February 2020 were analyzed retrospectively.Combined with clinical classification,the differences of various indexes between the critically ill group and the control group were compared,and the influencing factors of disease severity were analyzed by multivariate logistic regression.According to the corrected serum total calcium levels,patients were divided into low calcium group and normal calcium group,and the related indexes of the 2 groups were compared for further analyzing the causes of hypocalcemia.Results Compared with the control group,the age,diabetes,basic respiratory disease,and cardiovascular disease ratio,C-reactive protein(CRP),fasting blood glucose(FPG),interferonγ(IFN-γ),and interleukin 17(IL-17)levels increased while the lymphocyte percentage,serum albumin(ALB),corrected calcium levels,CD4+T cells percentage,CD8+T cell percentage decreased,the difference was statistically significant(P<0.05).There was no significant statistical difference in gender between the two groups,hypertension ratio,alanine aminotransferase(ALT),glomerular filtration rate(eGFR),CD4+/CD8+ratio and interleukin 4(IL-4)levels(P>0.05).The decrease of calcium level,age and eGFR were all risk factors for COVID-19 patients.Compared with the normal calcium group of COVID-19 patients,the level of ALB,CD4+T cells percentage,CD8+T cell percentage in low calcium group decreased and age,proportion of critically ill patients,diabetes,basic respiratory disease and cardiovascular disease ratio and CRP level all increased,the differences were statistically significant(P<0.05),and there was no statistical difference in the other biochemical indexes(P<0.05).Conclusion There are obvious hypocalcemia and immune dysfunction in critically ill patients of COVID-19,and close monitoring of blood calcium levels may predict the severity of the disease more effectively。
作者
汤莎莎
邓欣如
袁慧娟
Tang Shasha;Deng Xinru;Yuan Huijuan(Department of Endocrinology,Henan Provincial People′s Hospital,People′s Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2020年第8期667-672,共6页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金(81970705)。
关键词
血钙
新型冠状病毒肺炎
危重症
T细胞
Blood calcium
New coronavirus pneumonia
Critical condition
T cells
