广东省SARS病例血清学调查与分析

The detection of IgG antibody to SARS-associated coronavirus in SARS cases in Guangdong province

目的 分析广东省严重急性呼吸综合征 (SARS)病例SARS CoV抗体检出情况。方法 分别对 2 92份广东省SARS临床确诊病例、39份疑似病例和 30 3份健康体检人员 (一般人群 )血清标本 ,采用酶联免疫方法进行SARS冠状病毒IgG抗体检测。结果 SARS临床确诊病例的SARS CoVIgG抗体阳性率为 5 8 90 % (1 72 / 2 92 ) ,高于疑似病例及一般人群抗体阳性率 (分别为 1 8 0 0 %、2 31 % )(P <0 0 1 )。分析 2 92份临床确诊病例血清标本 ,结果显示有明确接触史者抗体阳性率 (72 6 7% )高于无明确接触史者 (4 1 98% ) (P <0 0 1 )。不同性别抗体阳性率差异无显著性 ,不同年龄组抗体阳性率差异有显著性 ,4 0～ 5 9岁年龄组最高 (P <0 0 1 )。流行早期病例抗体阳性率 (6 7 4 3% )高于后期(31 94 % )。SARS冠状病毒IgG抗体在发病 1 0d后能较可靠检出且能维持较长时间。结论 SARS冠状病毒IgG抗体检测结果与临床诊断存在一定差异 ,IgG抗体检测是有效的辅助诊断手段 ,但不能用于早期诊断。实验室血清学检测结果进一步证明接触史是SARS病例诊断的重要依据之一。

Objective To test the IgG Antibody to SARS CoV in probable and suspected SARS cases. Methods IgG Antibody to SARS CoV tested by ELISA. Results Serum specimen of 292 probable SARS cases, 39 suspected SARS cases and 303 controls from general people were tested. Positive rate of SARS CoV IgG in probable cases, suspected cases and controls were 58 90%, 18 00% and 2 31% respectively ( P <0 01). Among probable cases, the positive rate in those with clear contact history was 72 67% and only 41 98 % in those without clear contact history ( P <0 01). The positive rate in female and male has no significant difference, but there was a significant difference among age groups with the highest one in 40～59 age group( P <0 01). The positive rate in cases in the early stage of the outbreak was 67 43% and 31 94% in late stage. SARS CoV IgG can be detected in ten days after clinical symptom onset and can last a relatively long period. Conclusion The consistency between SARS CoV IgG test and clinical diagnosis was different in several ways. Detection of SARS CoV IgG is a good method of ancillary diagnosis. Contact history was one of the main epidemiologic criteria for SARS diagnosis.