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早期使用羟氯喹对新型冠状病毒肺炎患者胸部影像学改变的影响

Effects of hydroxychloroquine used in early time on the chest imaging changes of coronavirus disease 2019 (COVID-19) patients

    摘要
  • 摘要:
    目的 探讨含羟氯喹的不同治疗方案对新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)患者影像学改变的影响。
    方法 收集COVID-19患者的临床资料, 包括一般资料、临床表现、实验室检查结果、影像学表现、治疗方案、病情转归及预后。采用二元logistic回归模型分析不同治疗方案对患者肺部影像学进展的影响; 用Cox比例风险模型分析不同治疗方案对患者影像学好转时间的影响; 绘制Kaplan-Meier曲线, 分析早期应用羟氯喹对患者影像学预后的影响。
    结果 共纳入498例非轻型患者, 包括普通型430例(86.35%)、重型50例(10.04%)、危重型18例(3.61%), 中位年龄43(32, 59)岁。其中, 早期(确诊5 d内)使用羟氯喹者176例(35.34%)。早期使用羟氯喹可缩短患者胸部影像学改善时间(95% CI 0.517~0.870, P=0.003)。早期使用羟氯喹患者影像学好转中位时间为7 d, 未早期使用羟氯喹及未使用羟氯喹患者的胸部影像学好转中位时间为9 d, 差异有统计学意义(P < 0.01)。
    结论 早期使用羟氯喹能促进COVID-19患者肺部病变改善。

     

    Abstract:
    Objective To analyze the efficacy of multiple treatments including hydroxychloroquine used in early time on the chest imaging changes of coronavirus disease 2019(COVID-19) patients.
    Methods Clinical data including general information, clinical performance, lab indexes, imaging performance, treatment schemes, and prognosis were retrospectively collected.Binary logistic regression was used to screen the factors associated with advances in chest imaging, and Cox proportional hazards model was used to estimate the effects of prognostic factors on the improvement time in chest imaging.Kaplan-Meier curves were used to analyze the effect of hydroxychloroquine used early on imaging prognosis of patients.
    Results A total of 498 non-light patients were selected, including 48(86.35%) common patients, 50(10.04%) severe patients, and 18(3.61%) critical patients, with a median age of 43(32, 59) years.Among them, 176(35.34%) patients were treated with hydroxychloroquine.The early use of hydroxychloroquine was a favorable factor for the imaging improvement (95% CI 0.517-0.870, P=0.003).The median time to imaging improvement was 7 d in the hydroxychloroquine used early group, which was 9 d in the without hydroxychloroquine used group (P < 0.001).
    Conclusions Early use of hydroxychloroquine could improve chest imaging changes of patients with COVID-19.

     

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