协和医学杂志

2020, (06) 654-658

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新型冠状病毒肺炎与间质性肺炎的鉴别诊断
Differential Diagnosis between Coronavirus Disease 2019 and Interstitial Pneumonia

彭敏;孙雪峰;赵静;王京岚;宋兰;王孟昭;施举红;李太生;张奉春;蔡柏蔷;朱元珏;
PENG Min;SUN Xue-feng;ZHAO Jing;WANG Jing-lan;SONG Lan;WANG Meng-zhao;SHI Ju-hong;LI Tai-sheng;ZHANG Feng-chun;CAI Bai-qiang;ZHU Yuan-jue;Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Infectious diseasesPeking Union Medical College Hospital,Chine

摘要(Abstract):

2019年12月以来,我国陆续出现新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)病例,主要表现为发热、干咳、呼吸困难、外周血白细胞不高、淋巴细胞降低以及肺内阴影。国家卫健委在短期内连续7次修订诊疗方案,足以说明该病诊疗难度之大。部分COVID-19患者影像学表现为双肺弥漫性间质改变,与临床中所见的某些间质性肺炎相似。在当前全球COVID-19疫情形势仍极为严峻的情况下,需与某些急性或急进性间质性肺炎进行鉴别诊断,既要防止漏诊,又要防止因误诊而贻误原发病的治疗。本文将COVID-19与北京协和医院历年收治的多种间质性肺炎进行比较,提出了鉴别诊断思路。
Coronavirus disease 2019(COVID-19) emerged in China in late 2019, which was manifested as fever, cough, dyspnea, normal level of white blood cells, decreased blood lymphocytes, and pulmonary opacities on CT scans. National Health Commission of the People's Republic of China has revised the recommendations on COVID-19 seven times, but there are still many challenges in the diagnosis and management of COVID-19. The radiological findings in a proportion of patients revealed diffuse interstitial opacities, mimicking interstitial pneumonia. Thus it is essential to differentiate the COVID-19 from the acute and progressive diffuse interstitial lung diseases in order to avoid misdiagnosis or overdiagnosis. Therefore, our study compared COVID-19 with interstitial pneumonia and tried to explore the differential diagnostic algorithm.

关键词(KeyWords): 新型冠状病毒肺炎;间质性肺炎;鉴别诊断
coronavirus disease 2019;interstitial pneumonias;differential diagnosis

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作者(Author): 彭敏;孙雪峰;赵静;王京岚;宋兰;王孟昭;施举红;李太生;张奉春;蔡柏蔷;朱元珏;
PENG Min;SUN Xue-feng;ZHAO Jing;WANG Jing-lan;SONG Lan;WANG Meng-zhao;SHI Ju-hong;LI Tai-sheng;ZHANG Feng-chun;CAI Bai-qiang;ZHU Yuan-jue;Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Infectious diseasesPeking Union Medical College Hospital,Chine

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