恢复期SARS患者排泌物中SARS-CoV核酸的定量检测

Quantitative Detection of SARS-CoV RNA in Excreta and Oropharyngeal Washing Fluid from Convalescence Patients with Severe Acute Respiratory Syndrome

目的探讨恢复期严重急性呼吸综合征(SARS)患者是否携带病毒及具有传染性。方法选择SARS抗体(ELISA检测法)阳性的177例恢复期SARS患者,利用实时定量PCR法对患者的尿、粪便、咽漱液共531份标本中的SARS冠状病毒(SARS-CoV)核酸进行定量检测。结果177例患者中有49例(27.7%)标本病毒核酸检测阳性,其中31例(17.5%)1种标本阳性,14例(7.9%)2种标本阳性,4例(2.3%)3种标本阳性。尿、粪便、咽漱液的检出阳性率分别为14.7%(26例)、11.9%(21例)和13.6%(24例)。标本中病毒核酸的拷贝数在100～47000copies/ml之间,3种标本中病毒核酸不同拷贝数量级的患者阳性例数经χ2检验无明显差异。结论住院中的恢复期SARS患者约有十分之一仍然携带SARS-CoV。有必要将SARS冠状病毒核酸的实时定量PCR检测作为SARS患者出院与解除隔离的实验室指标。

Objective To detect the severe acute respiratory syndrome coronavirus(SARS-CoV)RNA in excreta and oropharyngeal washing fluid(OWF)from the convalescence SARS patients, and to determine whether convalescence patients carry the SARS-CoV, and whether having infectivity. Methods Totally 531 samples(including urine, stool, and OWF)were collected from 177 convalescence patients with positive SARS antibody which were confirmed by ELISA method. Real-time quantitative PCR was performed to detect the RNA of the SARS-CoV, and results were analyzed by SPSS analysis software. Results There were 49(27.7%)cases of SARS-CoV RNA detection positive in 177 patients, including 31(17.5%)cases with one sample positive, 14(7.9%)cases with two samples positive, and 4(2.3%)cases with three samples positive. The positive rates of urine, stool, and OWF were 14.7%(26/177), 11.9%(21/177), and 13.6%(24/177), respectively. The quantity of SARS-CoV RNA in samples was 100-47 000 copies/ml. No significant difference was found among urine, stool, and OWF on the difference grade quantity of SARS-CoV RNA quantity. Conclusions About 10% convalescence SARS patients might still carry the SARS-CoV in hospitalization. The detection of SARS-CoV RNA by real-time quantitative PCR may become a laboratory examination warranty for convalescence SARS patients to discharge hospital and relieve separation.