[Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia].
[Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia].
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DOI：
10.3760/cma.j.issn.1001-0939.2020.0005
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发表时间：
2020-02-06
期刊：
影响因子：
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通讯作者：
Wei, S
中科院分区：
文献类型：
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作者：
Chen, L;Liu, H G;Wei, S
目的：分析2019年新型冠状病毒（2019-nCoV）肺炎的临床特征，探讨血清炎性细胞因子与疾病严重程度的相关性。研究方法：选取2020年1月在华中科技大学同济医学院附属同济医院隔离病房收治的29例2019-ncov患者作为研究对象。收集患者的临床资料，分析患者的一般情况、临床症状、血液检查及CT影像学特点。根据相关诊断标准，将患者分为轻症组（15例）、重症组（9例）和危重组（5例）。检测各组患者血清中炎性细胞因子等指标的表达水平，比较分析3组患者这些指标的变化及其与疾病临床分型的关系。结果：（1）2019-nCoV肺炎主要症状为发热（28/29），伴或不伴呼吸道及其他全身症状。2例患者分别死于基础疾病和合并细菌感染。(2)患者的血液检查显示正常或白色血细胞计数减少（23/29），淋巴细胞计数减少（20/29），超敏C反应蛋白（hs-CRP）升高（27/29），降钙素原正常。大多数患者血清乳酸脱氢酶（LDH）显著升高（20/29），而白蛋白降低（15/29）。谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（Tbil）、血肌酐（Scr）等项目均无明显变化。(3)典型病例CT表现为单发或多发斑片状毛玻璃影伴间隔增厚。病情进展时，病灶增大，范围扩大，磨玻璃影与实性影或条纹影并存。(4)三组患者血清中IL-2 R和IL-6的表达水平差异有统计学意义（P0. 05）。结论：2019-nCoV肺炎的临床特征与普通病毒性肺炎相似。高分辨率CT对本病的鉴别诊断有重要价值。血清中IL-2 R和IL-6的表达增加有望预测2019-nCoV肺炎的严重程度和患者的预后。
Objective: To analyze the clinical characteristics of 2019 novel coronavirus (2019-nCoV) pneumonia and to investigate the correlation between serum inflammatory cytokines and severity of the disease. Methods: 29 patients with 2019-ncov admitted to the isolation ward of Tongji hospital affiliated to Tongji medical college of Huazhong University of Science and Technology in January 2020 were selected as the study subjects. Clinical data were collected and the general information, clinical symptoms, blood test and CT imaging characteristics were analyzed. According to the relevant diagnostic criteria, the patients were divided into three groups: mild (15 cases), severe (9 cases) and critical (5 cases). The expression levels of inflammatory cytokines and other markers in the serum of each group were detected, and the changes of these indicators of the three groups were compared and analyzed, as well as their relationship with the clinical classification of the disease. Results: (1) The main symptoms of 2019-nCoV pneumonia was fever (28/29) with or without respiratory and other systemic symptoms. Two patients died with underlying disease and co-bacterial infection, respectively. (2) The blood test of the patients showed normal or decreased white blood cell count (23/29), decreased lymphocyte count (20/29), increased hypersensitive C reactive protein (hs-CRP) (27/29), and normal procalcitonin. In most patients,serum lactate dehydrogenase (LDH) was significantly increased (20/29), while albumin was decreased(15/29). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil), serum creatinine (Scr) and other items showed no significant changes. (3) CT findings of typical cases were single or multiple patchy ground glass shadows accompanied by septal thickening. When the disease progresses, the lesion increases and the scope expands, and the ground glass shadow coexists with the solid shadow or the stripe shadow. (4) There were statistically significant differences in the expression levels of interleukin-2 receptor (IL-2R) and IL-6 in the serum of the three groups (P0.05). Conclusion: The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. High resolution CT is of great value in the differential diagnosis of this disease. The increased expression of IL-2R and IL-6 in serum is expected to predict the severity of the 2019-nCoV pneumonia and the prognosis of patients.