不同疾病人群血清中呼吸道合胞病毒特异性抗体IgM、IgG和IgA的分析

Analysis of IgM,IgG and IgA specific antibodies of respiratory syncytial virus in sera of people with different diseases

目的探讨呼吸道合胞病毒(RSV)特异性抗体IgM、IgG和IgA在不同疾病人群中的分布情况。方法运用荧光定量聚合酶链反应技术(FQ-PCR)筛选出50例咽拭子呼吸道合胞病毒(RSV)阳性有呼吸道感染症状的患儿作为观察组,同时以125例无呼吸道感染症状的不同疾病血清标本作为对照组。采用酶联免疫吸附试验(ELISA)检测患儿血清中的特异性抗体IgM、IgG和IgA水平。结果 IgM在观察组检出率仅为24.0%,在支气管肺炎和急性支气管炎中的检出率最高,分别为46.0%和58.7%;IgM、IgG和IgA在对照组不同疾病中检出率分别为6.4%、96.0%和20.0%;IgG在母婴对照组检出率均为100.0%,且抗体水平两组基本一致;IgA在<0.5岁、>0.5~1岁、>1~5岁和>5岁年龄段检出率分别为7.5%、27.8%、84.4%和97.6%。结论 IgM只能作为RSV早期感染的辅助诊断指标;母婴IgG抗体存在垂直传播,可能为机体保护性抗体;IgA随年龄增长越容易产生;RSV在儿童中主要引起支气管肺炎和急性支气管炎,且在不同疾病及不同年龄段存在较高隐性感染。

Objective To evaluate the respiratory syncytial virus(RSV) specific IgM,IgG and IgA antibodies in sera of people with different diseases.Methods 50 cases of RSV positive and with symptoms of respiratory tract infection were selected as observation group.125 cases of different diseases with no symptoms of respiratory tract infection were selected as control group.RSV was detected by fluorescence quantitative polymerase chain reaction(FQ-PCR).RSV specific serum IgM,IgG and IgA antibodies were detected by enzyme-linked immunosorbent assay(ELISA).Results The detection rate of RSV specific IgM in the observation group was only 24.0%,and the detection rates in bronchopneumonia and acute bronchitis were 46.0% and 58.7%,respectively;the detection rates of RSV specific IgM,IgG,and IgA in different diseases of the control group were 6.4%,96.0% and 20.0%,respectively;the detection rate of IgG in the maternal and infant control group was 100.0%,and the antibody levels were basically the same in both groups.The detection rates of RSV specific IgA in the age group of <0.5 years,>0.5-1 years,>1-5 years and>5 years The detection rates were 7.5%,27.8%,84.4% and 97.6%,respectively.Conclusion IgM could only be used as an auxiliary diagnostic index for early RSV infection.Vertical transmission of IgG antibodies from maternal to infant might be protective antibodies.RSV specific IgA levels were increased with age.RSV might have higher hidden infections in different diseases and different ages.