目的 分析2019新型冠状病毒(2019-nCoV)肺炎患者的临床特征,研究患者血清中炎症相关细胞因子与病情严重程度的相关性.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患者为研究对象,收集临床资料,分析一般情况、临床症状、血液检验及CT影像学的特征.根据相关诊断标准将患者分为普通型(15例)、重型(9例)和危重型(5例)3组.检测各组患者血清中炎症相关细胞因子及其他反映病情变化标志物的表达水平,比较和分析3组患者血清中上述各指标变化的规律及其与疾病临床分型的关系.结果 (1)2019-nCoV肺炎患者的主要临床症状为发热(28/29),伴或不伴有呼吸道及其他系统症状;2例死亡患者分别合并基础疾病和混合细菌感染.(2)患者外周血一般表现为白细胞总数正常或减低(23/29),淋巴细胞计数减少(20/29),超敏C反应蛋白(hs-CRP)增高(27/29),降钙素原正常.多数患者血清中乳酸脱氢酶(LDH)表达水平明显增高(20/29),白蛋白减低(15/29);而丙氨酸氨基转移酶(ALT),天冬氨酸氨基转移酶(AST),总胆红素(Tbil),血肌酐(Scr)等指标无明显变化.(3)典型病例的CT表现为单发或多发的斑片状磨玻璃影,伴有小叶间隔增厚;疾病进展时病灶增多、范围扩大,磨玻璃影与实变影或条索影共存,部分重症患者表现为双肺弥漫性病变.(4)3组患者血清中白细胞介素-2受体(IL-2R)、IL-6表达水平差异均具有统计学意义(P＜0.05),其中危重型高于重型、重型高于普通型.而3组研究对象血清中的肿瘤坏死因子-α(TNF-α)、IL-1β、IL-8、IL-10、hs-CRP、淋巴细胞计数、LDH表达水平差异均无统计学意义(P＞0.05).结论2019新型冠状病毒肺炎的临床特征与一般病毒性肺炎类似;高分辨率CT有助于鉴别诊断;患者血清中IL-2R、IL-6表达水平有助于疾病临床分型,可能有助于预测新冠肺炎的严重程度和预后.“,”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 (P＜0.05),among which the critical group was higher than the severe group and the severe group was higher than the mild group.However,there were no statistically significant differences in serum levels of tumor necrosis factor-alpha (TNF-α),IL-1,IL-8,IL-10,hs-CRP,lymphocyte count and LDH among the three groups (P＞0.05).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.