SARS患者及其医护人员血中特异IgG抗体变化规律的初步研究

Primary investigation on the changing mode of plasma specific IgG antibody in SARS patients and their physicians and nurses

目的 :对临床诊断严重急性呼吸道综合征 (SevereAcuteRespiratorySyndrome,SARS ,即非典型肺炎 )患者血抗SARS冠状病毒IgG抗体的变化规律和密切接触SARS患者的医护人员有无隐性感染作初步调查。 方法 :用酶联免疫吸附测定 (ELISA)检测 5 7例正常人、12 7例在SARS病房工作 1个月的医护人员和 73例不同病程SARS患者血浆抗SARS冠状病毒IgG抗体的水平。 结果 :正常人和医护人员血浆中尚未检测到抗SARS冠状病毒IgG抗体。SARS患者发病第 0～ 7、8～ 10、11～ 14、15～ 2 0天后血浆中抗SARS冠状病毒IgG抗体的阳性率分别为 0、33%、5 2 %和 86 % ,总阳性率为 6 1%。结论 :ELISA检测血浆中抗SARS冠状病毒IgG抗体的特异性和敏感度均很好。呈阳性反应病例可确诊已受病毒感染 ,对于发病早期还未产生抗体的病人 ,阴性结果不能说明未受感染 ,应做进一步观察。

Objectives: To primarily investigate the changing mode of anti SARS coronavirus IgG antibody in clinically diagnosed SARS patients and the possibility of subclinical infection in physicians and nurses through close association with SARS patients. Methods: The plasma levels of anti SARS coronavirus IgG antibody of 57 normal subjects, 127 physicians and nurses worked in SARS wards for one month and 73 SARS patients with different course of SARS were measured by enzyme linked immunosorbent assay. Results: Plasma anti SARS coronavirus IgG antibody was not detected in normal subjects and the clinical personnel. After 0～7 days,8～10 days,11～14 days,15～20 days of onset of disease, the positive rates were 0,33%,52%,86% respectively, and the general positive rate was 61%. Conclusion: The specificity and sensitivity of ELISA to detect plasma anti SARS IgG antibody were satisfactory. Cases with positive reaction could be diagnosed as patients already infected by the virus. The specific IgG antibody didn't emerge in some patients in the early stage of the disease, and the negative results didn't indicate that they were not infected. And follow up investigation should be made in those patients. Unlike common epidemic infectious diseases, SARS probably hadn't the potentiality of subclinical infection.