天津地区新型冠状病毒肺炎患者特异性IgM和IgG动态变化研究  

Kinetics of specific IgM and IgG antibodies in patients with COVID-19 in Tianjin

作　　者：王星[1] 吴茜[1] 李红蔚[1] 华静娜[1] 李莉[1] 秦中华[2] WANG Xing;WU Qian;LI Hong-wei;HUA Jing-na;LI Li;QIN Zhong-hua(Department of Respiratory and Critical Care Medicine,Tianjin Haihe Hospital,Tianjin Respiratory Disease Research Institute,Tianjin 300350,China;Department of Laboratory,Tianjin Haihe Hospital,Tianjin Respiratory Disease Research Institute,Tianjin 300350,China)

机构地区：[1]天津市海河医院呼吸与危重症医学科、天津市呼吸疾病研究所,300350 [2]天津市海河医院检验科天津市呼吸疾病研究所,300350

出　　处：《天津医药》2021年第1期41-44,共4页Tianjin Medical Journal

基　　金：天津市卫生健康新冠肺炎防治科技项目(2020XKZ02);天津市科技重大专项与工程(20ZXGBSY00100)。

摘　　要：目的动态检测与评估重症与非重症新冠病毒肺炎(COVID-19)患者血清特异性IgM和IgG水平及其变化规律。方法收集天津地区2020年1月21日—3月15日确诊的30例新冠病毒肺炎患者血清,重症组20例,非重症组10例,动态检测新型冠状病毒(SARS-CoV-2)特异性IgM和IgG抗体,并进行纵向分析。结果患者发病0~6 d,IgM和IgG阳性率分别为42.86%和28.57%,随着病程的进展,2种抗体的阳性率逐步增高,在大约5周后阳性率开始下降。重症组与非重症组患者在发病后约28 d内IgM、IgG水平逐步升高,28 d后开始下降,重症组患者IgM、IgG水平下降明显。重症组患者在发病后28~33 d IgG水平较非重症组高,差异有统计学意义(P<0.05)。重症组恢复期IgG水平较非重症组高(P<0.05)。结论COVID-19患者特异性IgM和IgG抗体水平随病程进展先升高后降。重症较非重症组患者特异性IgG抗体水平高。高水平的IgG可能是病情危重的预警指标。Objective To dynamically detect and evaluate the serum specific levels of IgM and IgG and their variation patterns in critical and non-critical patients with COVID-19.Methods Serum samples of 30 COVID-19 patients diagnosed in Tianjin from January 21,2020 to March 15,2020 were collected consecutively,including 20 critical cases and 10 non-critical cases.The SARS-COV-2 specific IgM and IgG antibodies were dynamically detected and analyzed vertically.Results The positive rates of specific IgM and IgG in 0-6 days after symptom onset were 42.86% and 28.57%,respectively.As the course of the disease progresses,the positive rates of both antibodies increased gradually,and began to decrease after 5 weeks.Within 28 days after the symptom onset,the IgM and IgG levels were increased gradually in both critical and non-critical patients,and which started to decrease after 28 days.Especially for the critical patients,the IgM and IgG levels decreased obviously.The IgG levels were significantly higher in critical patients than those of non-critical patients in 28-33 days after the symptom onset(P<0.05).In the recovery phase,the IgG levels were significantly higher in critical patients than those of non-critical patients(P<0.05).Conclusion The specific IgM and IgG antibody levels of COVID-19 patients first increase and then decrease as the disease progressed.Compared with non-critical patients,the specific IgG is higher in critical patients.The high level of IgG may be a warning index of critical situation.

关 键 词：肺炎 病毒性 冠状病毒属 抗体 免疫球蛋白G 免疫球蛋白M 天津 新冠肺炎 新型冠状病毒 

分 类 号：R563.1[医药卫生—呼吸系统]