发热伴血小板减少综合征患者血清新布尼亚病毒IgM抗体动态变化及其临床意义

Fever with thrombocytopenia syndrome patients＇ serum new Buniavirus IgM antibodies dynamic and its clinical significance

目的 了解发热伴血小板减少综合征病例血清中新型布尼亚病毒IgM抗体动态变化规律以弥补新型布尼亚病毒核酸检测阴性病例早期诊断的方法缺失,为临床正确治疗提供诊断依据.方法 选择首份血清检测结果为新型布尼亚病毒核酸检测阳性而IgM抗体检测阴性的确诊病例,连续留取患者隔天血清样本直至出院,用Mac-ELISA方法检测留取的血清中新型布尼亚病毒IgM抗体阳转时间与动态变化,计算阳转时间构成比及平均阳转时间.结果符合研究要求的16例患者发病后血清中新型布尼亚病毒IgM抗体阳转时间：5d：2/16;7 d：6/16;9 d：9/16;11 d：10/16;13 d：12/16;15 d：16/16,平均阳转时间为（10.25±3.58）d.结论 16例发热伴血小板减少症患者血清中新型布尼亚病毒IgM抗体均可阳转,最早可在发病后5d、最迟为15 d、阳转后患者血清中的抗体浓度逐步升高,直至病后30 d仍可高水平维持.16例患者的恢复期血清IgG抗体滴度较急性期增高4倍以上.新型布尼亚病毒IgM抗体检测可以作为发热伴血小板减少综合征病例早期诊断的辅助方法.

Objective Learning the dynamic changes of serum new Buniavirus IgM antibody of fever with thrombocytopenia syndrome cases to cover the missing of early diagnosis method for new Buniavirus nucleic acid detecting negative cases,provide the basis for clinical diagnosis and correct treatment.Methods Select the confirmed cases that the first serologic test results for the new Buniavirus nucleic acid testing is positive and negative for IgM antibody test,reserve the consecutive serum samples from patients which is taken every other day until leaving hospital,use Mac-ELISA method to detect the serum specimens of the new Buniavirus IgM seroconversion time and dynamic changes,and calculate the percentage of seroconversion time and the average seroconversion time.Results The new Buniavirus IgM seroconversion time proportions of the serum of the 16 patients who meet the requirements of the study after the onset of disease：5 d：2/16;7 d：6/16;9 d：9/16;11 d：10/16;13 d：12/16;15 d：16/16,and the average seroconversion time is 10.25 ± 3.58 days.Conclusions The serum new Buniavirus IgM antibody of the 16 fever with thrombocytopenia cases can be conversed as early as five days after the onset of disease and the latest with 15 days,then the density of the patient＇s serum antibody gradually increases after 基金 DOI：10.3760/cma.j.issn.1003-9279.2014.04.00 seroconversion and until 30 days after the disease can still maintain a high level.The convalescent serum IgG antibody titer of the 16 patients is 4 times more than the acute phase.New Buniavirus IgM antibodies detection can be used as an auxiliary method of the early diagnosis of fever with thrombocytopenia syndrome cases.