五例新型冠状病毒肺炎确诊患者出院后核酸检测"复阳"的病例分析  

Re-positive nucleic acid detection in COVID-19 patients after discharge from hospital

作　　者：智深深 许毅[2] 陈耀凯[3] 孟小容 张薇 张钦红[1] 白伟志[5] 周莹冰[4] 罗昱玥 李丽娟 刘鉴达 李维[1] Zhi Shenshen;Xu Yi;Chen Yaokai;Meng Xiaorong;Zhang Wei;Zhang Qinhong;Bai Weizhi;Zhou Yingbing;Luo Yuyao;Li Lijuan;Liu Jianda;Li Wei(Clinical Laboratory of Chongqing Emergency Medical Center,Chongqing 400014,China;Department of Medical Affairs of Chongqing Emergency Medical Center,Chongqing 400014,China;Infectious Disease Department of Chongqing Public Health Medical Center,Chongqing 400036,China;Clinical Laboratory of Yuzhong District Center for Disease Control and Prevention of Chongqing,Chongqing 400010,China;Emergency Department of Medical Affairs of Chongqing Emergency Medical Center,Chongqing 400014,China)

机构地区：[1]重庆市急救医疗中心检验科,重庆400014 [2]重庆市急救医疗中心医务科,重庆400014 [3]重庆市公共卫生医疗救治中心感染科,重庆400036 [4]重庆市渝中区疾病预防控制中心检验科,重庆400010 [5]重庆市急救医疗中心急诊科,重庆400014

出　　处：《中华检验医学杂志》2020年第9期923-926,共4页Chinese Journal of Laboratory Medicine

基　　金：重庆市中青年医学高端人才工作室项目 (ZQNYXGDRCGZS2019008)。

摘　　要：持续监测重庆市某医院治愈患者出院后新型冠状病毒核酸及抗体(IgM与IgG总抗体)的检测情况,发现5例核酸"复阳"现象,5例患者抗体均呈阳性,且有随时间递增的趋势。"复阳"可能与以下3种因素有关:(1)儿童无症状感染者粪便排毒时间较长;(2)各种原因导致出院检测时出现连续两次核酸检测"假阴性";(3)患者体内病毒清除并不完全,而出院标准不够保守。分析"复阳"现象可能的原因,探讨其有无传染性,有助于揭示新型冠状病毒更多的特点。Cases of 2019-nCoV nucleic acid and antibody(IgM and IgG total antibody)after discharge from a hospital in Chongqing were continuously monitored.It was found that 5 cases of"re-positive"phenomenon,5 cases of antibody were positive,and there was a trend of increasing with time."Re-Positive"may be related to the following three factors.Children with asymptomatic infection had a long time of fecal detoxification.There were two consecutive nucleic acid tests"false negative"caused by various reasons.The virus clearance in patients was not complete,and the discharge standard was not conservative enough.The analysis of the causes of"Re-Positive"patients and the discussion of its infection will help us reveal more characteristics of this virus,and to provide a new basis for the discharge standard in the constantly updated diagnosis and treatment programme.

关 键 词：新型冠状病毒肺炎 核酸类 假阴性反应 免疫球蛋白M 免疫球蛋白G 

分 类 号：R563.1[医药卫生—呼吸系统] R44[医药卫生—内科学]