【摘要】 目的评估血浆D-二聚体(D-dimer, D-D)与新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)重症化的相关性。方法回顾性分析2020年1月20日—2月8日在阜阳市第二人民医院住院的102例COVID-19患者的临床资料,将患者按血浆D-D是否升高分为D-D不升高组与D-D持续升高组,比较2组患者的临床资料,并进行倾向性评分匹配及生存分析,评价D-D水平对于COVID-19重症化的作用。结果最终纳入102例COVID-19确诊患者,中位年龄42.2(31.7,49.6)岁,60例(58.8%)为男性,19例(18.6%)存在基础疾病,6例(5.9%)有吸烟史,7例(6.9%)有间断饮酒史,74例(72.5%)有流行病学史。与D-D不升高组(n=85)相比,D-D持续升高组(n=17)患者的年龄更高,其中年龄> 50岁的患者占58.8%,淋巴细胞绝对值更低,LDH水平更高(P均<0.05)。D-D持续升高组有8例患者出现了重症化(47.1%),D-D不升高组有7例(8.2%)出现重症化(P <0.05)。基于多因素Logistic回归进行匹配,匹配成功后D-D升高组有8例(47.1%)患者出现了重症化,D-D不升高组有4例(11.8%)出现重症化(P <0.05),CoX风险比例回归分析结果显示D-D持续升高是疾病进展的独立风险因素,其HR为4.372(95%CI:1.313～14.556)。结论血浆D-D的持续升高是COVID-19重症化的高危因素。更多还原

【Abstract】 Objective To evaluate the correlation between plasma D-dimer(D-D) level and acute exacerbation of coronavirus disease 2019(COVID-19). Methods A retrospective analysis was performed for the clinical data of 102 COVID-19 patients who were admitted to the No. 2 People’s Hospital of Fuyang City from January 20, 2020 to February 8, 2020. The patients were divided into 2 groups according to the absence or presence of the increasing plasma D-D: non-increasing D-D group and continuously increasing D-D group. The clinical data of patients in 2 groups were compared. Propensity score matching and survival analysis were carried out to evaluate the impact of plasma D-D level on the acute exacerbation of COVID-19. Results Finally, 102 confirmed patients were included. Their median age was 42.2(31.7, 49.6) years, including 60(58.8%) male cases, 19(18.6%) cases had underlying diseases, 6(5.9%) cases had smoking history, 7(6.9%) cases had intermittent drinking history, and 74 cases(72.5%) had epidemiological history.In the continuously increasing D-D group(n=17), the age of patients was higher and patients aged > 50 years accounted for 58.8%,the absolute lymphocyte count was lower. The LDH level was higher than that in non-increasing D-D group(n=85)(P <0.05). Eight patients(47.1%) in the continuously increasing D-D group and 7 patients(8.2%) in the non-increasing D-D group developed acute exacerbation(P <0.05). The propensity score matching was performed based on multivariate Logistic regression. After successful matching, 8 patients(47.1%) in the continuously increasing D-D group and 4 patients(11.8%) in the non-increasing D-D group developed acute exacerbation(P <0.05). CoX risk proportional regression analysis showed that continuously increasing D-D was an independent risk factor for disease progression, with its hazard ratio(HR) of 4.372(95% CI: 1.313-14.556). Conclusions The continuously increasing plasma D-D is a high-risk factor for acute exacerbation of COVID-19.更多还原