不同地区人群SARS血清流行病学调查  

Seroepidemiological study On SARS-CoV IgG antibody of different populations from several areas

作　　者：石玉玲 李林海 陈清[2] 楚心唯[2] 王云龙 马清钧[4] 曹诚[4] 俞守义[2] 

机构地区：[1]广州军区广州总院检验科,广州510010 [2]第一军医大学流行病学教研室 [3]河南省生物工程技术研究中心 [4]军事医学科学院生物工程研究所

出　　处：《中国公共卫生》2004年第12期1476-1477,共2页Chinese Journal of Public Health

基　　金：国家自然科学基金资助项目 (30 340 0 1 4 ) ;广东省SARS科研基金资助项目 (2 0 0 3非典 0 3 - 0 3)

摘　　要：目的　分析严重急性呼吸综合征 (SevereAcuteRespiratorySyndrome ,SARS)流行期间不同地区人群及SARS临床诊断病例血清特异性抗体 (SARS -CoVIgG)变化规律以及健康人群是否存在隐性感染。方法　采用酶联免疫方法 (ELISA)及间接免疫荧光法 (IFA) ,对香港、澳门、北京、广州地区 14 5 3名健康人及广州和北京地区 2 5 7例SARS临床诊断病例进行血清SARS -CoVIgG抗体检测 ,并跟踪检测患者病后不同时间 (发病 3～ 2 70d)血清抗体变化情况。结果　 4个地区健康人群 (包括 16 0名密切接触者 )中 ,用ELISA法检出 2例SARS -CoVIgG抗体阳性 ,阳性者进一步用IFA检测则为阴性 ;广州地区 2 0 0名健康体检者同时采用ELISA和IFA检测 ,结果均为阴性。ELISA和IFA同时检测 2 5 7例临床诊断病例发病 2 0d后的血清SARS -CoVIgG抗体 ,2种方法检出的阳性率均为 90 %。ELISA法跟踪检测 2 5 7例临床诊断病例发病后 3～ 2 70d血清IgG抗体 ,抗体滴度在发病后 4～ 6个月内随时间延长逐渐升高 ,多数病人抗体在第 4～ 6个月达到高峰 ,并持续到第 8个月 ,部分病人抗体达高峰后开始下降 ,但至第 9个月仍阳性。结论　健康人群中隐性感染率极低 ,血清SARS -CoVIgG抗体在病程后期有诊断价值 ,血清特异性抗体可持续 9个月以上。Objective To analyze dynamic rules of SARS coronavirus( S ARS-CoV) IgG antibody of probable patients with severe acute respiratory syndrom e(SARS) during the epidemic period in 2003 and whether the asymtomatic infection s existing in healthy population from several areas. Methods Indirect immunofluorescent assay(IFA) and double- antigen sandwich enzyme-linked immunosorbent assay (ELISA) were used to detect t he SARS coronavirus-specific IgG antibodies in serum specimens,including 1453 he althy persons from Hongkong,Marco,Guangzhou and Peking and 257 SARS probable pat ients from Guangzhou and Peking.The dynamics of the serum antibodies of SARS pat ients were observed from 3 to 270 days after onset of symptoms. Results Among healthy persons including 160 close contact ers of SARS patient,only 2 were positive by the sandwich ELISA.These two specim ens were negative by IFA.90% of 257 patient serum specimens after 20 days of dis ease onset showed positive SARS-CoV IgG either using ELISA or IFA.Of 257 SARS pa tients,antibody titers increased steadily in early 4 to 6 months after onset of SARS.The titers of most cases came to the peak in the 6th month and maintained t he titers for two months. Then antibody titers declined in some cases.However,a ll specimens still were positive for SARS-CoV IgG in the 9th month of the diseas e onset.Conclusion Few asymtomatic infectious patients may exist during SARS epidemic.Serum IgG antibody has diagnostic value for SARS in the lat e course of the disease and the antibodies present more than 9 months.

关 键 词：严重急性呼吸综合征 血清流行病学 SARS-CoY IGG抗体 

分 类 号：R181.36[医药卫生—流行病学]