中和抗体在流行性出血热病程中的动态改变及意义

DYNAMICS AND CLINICAL SIGNIFICANCE OF NEUTRALIZING ANTIBODY IN PATIENTS WITH EPIDEMIC HEMORRHAGIC FEVER

采用微量细胞病变中和试验对１５例流行性出血热（ＥＨＦ）患者的中和抗体进行了动态检测。第３病日即可检出，５病日内检出率为７８％（７／９），至第１５～１６病日达高峰，中和抗体的滴度变化与ＥＨＦ的病期和病型有明显关系，轻型、中型、重型患者随病程进展而升高，危重型患者发热期滴度最高，死亡前中和抗体滴度明显降低；中和抗体的滴度与尿蛋白的变化呈负相关。动态检测中和抗体的滴度变化可反映患者的转归和预后，若重症患者中和抗体极度降低，则预后不良，这对探索ＥＨＦ的发病机理有重要意义。

The dynamics of neutralizing antibody(NAb) in 15 patients with epidemic hemorrhagic fever(EHF) was deterined by micro-CPE neutralization test (MCPENH). The NAb could be discovered on day 3 after the onset of the disease and the NAb positive rate was 78% (7/9) within day 5 after the onset. The NAb titres reached its peak during day 15～16 after the onset and stabilized from then on. The levels of NAb titres had apparent relations both to the stages and the types of the disease. In mild middle and severe types of patients, NAb titres increased with the progression of the course of the disease in severe type of patients, NAb titres were the highest during febrile stage and they fell sharp before death in the dying cases. The NAb titres had a regatively relative tendency to the protien level in the patients urine. These results suggest that the NAb dynamics in EHF patients may directly reflect the prognosis of the patients and the NAb has an important significance in the pathogenesis of EHF.