传播链和非传播链SARS患者中SARS冠状病毒抗体的分布及变化规律  

Distribution and timing of antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain

作　　者：吴立平[1] 梅志强[1] 王乃昌[1] 赵习芳[1] 那丹宇[1] 郑蕾[1] 张莉媛[1] 任泽萍[1] 付士红 梁国栋 

机构地区：[1]山西省疾病预防控制中心,030012 [2]中国CDC病毒病预防控制所

出　　处：《中华实验和临床病毒学杂志》2004年第2期109-112,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：国家 8 63生物高技术重大专项资助课题 (2 0 0 3AA2 0 840 5 ) ;山西省财政专项资助项目

摘　　要：目的　探讨人体对SARS CoV血清抗体反应及分布规律。方法　对 30 1例临床诊断病例的血清标本 (其中传播链上的病例 15 8例 ,非传播链病例 14 3例 ) ;采用北京华大GBI生物技术有限公司生产的间接ELISA试剂 ,进行SARS CoVIgG抗体的检测 ,部分病例还进行了SARS CoVIgM的检测。结果　传播链涉及 15条 ,最多涉及 4代 ,各条链的SARSIgG抗体阳性率为 85 70 %～ 10 0 .0 0 % ,总阳性率为 94 30 % (14 9 15 8)。SARS病例数随代数增加而减少。但各代间IgG阳性率的差异无显著意义 ;χ2 =5 11,P >0 0 5。非传播链病例的血清抗体阳性率为 12 5 9% (18 14 3)。与传播链的阳性率比较 ,两者间的差异有显著意义 ;χ2 =199 6 4 ,P <0 0 0 1。在发病后的 0～ 7d、8～ 14d、15～ 2 1d、2 2～ 30d内 ,SARS CoVIgG的累计阳性率分别为 16 6 7%、4 0 0 0 %、70 0 0 %、93 10 % ;然后进入平台期 ,并可以维持 6个月以上。在发病 7d内 ,SARS CoVIgM的累计阳性率为 16 6 7% ,8～ 14d时 ,已有 5 5 17%的标本IgM抗体阳转 ,在 2 1～ 30d时 ,抗体阳性率达高峰 (86 96 % ) ,以后迅速下降。结论　SARS感染后 ,94 %的感染者可产生IgG抗体。检测该抗体可以作为临床核实诊断的依据。SARS CoVIgG抗体在 7d时可能检出 ,一般在Objective To find out the timing of serologic responses after illness onset and distribution of IgG antibody to SARS-CoV in SARS cases of transmission chain or non-transmission chain. Methods The IgG and IgM antibodies to SARS-CoV were tested by indirect ELISA in serum samples from 301 clinically diagnosed SARS cases. Results Totally 158 SARS cases were involved in 15 chains of transmission. The positive rates of SARS-CoV IgG in those chains were 85.70%-100.00% and the overall rate was 94.30%(149/158).The chain of transmission could spread to four generations,but the SARS cases were reduced with increase of generations. There was no significant difference among positive rates of SARS-CoV IgG for generations,χ 2=5.11,P >0.05. The positive rate of SARS-CoV IgG in cases who were not in chain of transmission was 12.59%(18/143) which was statistically significantly different from that of cases in chain of transmission,χ 2=199.64,P <0.001. During days 0-7,8-14,15-21,22-30 after onset,the cumulated positive rate of SARS-CoV IgG was 16.67%,40.00%,70.00% and 93.10%,respectively,then was kept at the level above 90% and lasted for 217 days. The cumulated positive rate of SARS-CoV IgM during days 0-7 after onset was the same to that of IgG. During days 8-14,55.17% of cases had seroconvertation for IgM which reached a peak (86.96 %) during days 21-30. Then the rate rapidly declined. Conclusion More than 94%of cases with SARS could produce IgG antibody when they were infected by SARS-CoV. Detecting SARS-CoV IgG could provide a diagnostic evidence for case confirmation. SARS-CoV IgG appeared as early as 7 days after onset and reached the peak at about weeks 4. Then the high rate of antibody was maintained for more than 6 months.

关 键 词：传播链 非传播链 SARS 冠状病毒 抗体 严重急性呼吸综合征 

分 类 号：R511.9[医药卫生—内科学]