新型冠状病毒核酸检测与特异性IgM抗体检测的比较分析  

A comparative analysis of nucleic acid detection and specific IgM antibody detection in the diagnosis of novel coronavirus

作　　者：许伟伟 朱华 孙卫和 XU Weiwei;ZHU Hua;SUN Weihe(Department of Critical Care Medicine,Dongtan People′s Hospital,Nantong University,Dongtai,Jiangsu 224200,China;Department of Medical Imaging,Dongtan People′s Hospital,Nantong University)

机构地区：[1]南通大学附属东台医院重症医学科,江苏东台224200 [2]南通大学附属东台医院影像科

出　　处：《徐州医科大学学报》2021年第4期310-312,共3页Journal of Xuzhou Medical University

摘　　要：目的分别用实时荧光定量RT-PCR方法检测新型冠状病毒(SARS-Co V-2)核酸,用荧光免疫层析方法检测SARS-Co V-2特异性Ig M抗体,对2种方法进行比较分析,为新型冠状病毒肺炎(COVID-19)的诊断提供参考。方法选择82例COVID-19疑似患者,从出现临床症状当天至第21天,分别检测患者的鼻咽拭子样本SARS-Co V-2核酸阳性率和全血样本中SARS-Co V-2 Ig M抗体阳性率。同时选取南通大学附属东台医院排除COVID-19的50例医务人员作为对照组。结果 COVID-19疑似患者组核酸检测方法检测出74例SARS-Co V-2阳性,阳性率为90.24%;对照组有1例样品一过性阳性,阳性率为2.00%。COVID-19疑似患者组Ig M抗体检测方法检测出66例SARS-Co V-2阳性,阳性率为80.49%;对照组Ig M抗体检测均为阴性。核酸检出时间为发病第1~18天,检出高峰期为第1~8天;Ig M抗体检出时间为发病第3~19天,检出高峰期为第5~14天。结论 Ig M抗体检测方法检测SARS-Co V-2阳性的高峰期比核酸检测方法滞后约1周,2种方法结合检测可实现互补,对排毒量低于核酸检测临界值的COVID-19确诊有重要意义。在临床诊断中将核酸检测方法和血清学检测方法相结合确诊COVID-19病例更为可靠。Objective To compare real-time fluorescence quantitative RT-PCT and fluorescence immunochromatography for detection of the nucleic acid of novel coronavirus(SARS-CoV-2),so as to provide reference for the diagnosis of corona virus disease 2019(COVID-19).Methods A total of 82 suspected COVID-19 patients were selected.Their positive rates of SARS-CoV-2 nucleic acid in nasopharyngeal swab samples and IgM antibody in whole blood samples were detected from the day when clinical symptoms appeared until 21 days later.Meanwhile,50 medical staff without COVID-19 in Dongtan People's Hospital were selected as a control group.Results Based on nucleic acid detection method,74 SARS-CoV-2 positive cases were found in the COVID-19 suspected patient group,with a positive rate of 90.24%,while there was one temporarily positive case in the control group,with a positive rate of 2.00%.Based on IgM antibody detection method,66 SARS-CoV-2 cases were detected in the COVID-19 suspected patient group,with a positive rate of 80.49%,while all the samples were negative in the control group.The detection time of nucleic acid was from Days 1 to 18,reaching a peak from Days 1 to 8.The detection time of IgM antibody was from Days 3 to 19,reaching a peak from Days 5 to 14.Conclusions The peak period of IgM antibody detection is about one week behind the peak period of nucleic acid detection.Both methods are complementary,which is of importance to diagnose COVID-19 with a detoxification volume less than the nucleic acid concentration threshold.It is more reliable to use both nucleic acid and serological detection methods for COVID-19 diagnosis.

关 键 词：新型冠状病毒肺炎 新型冠状病毒 核酸检测 IGM抗体 

分 类 号：R446[医药卫生—诊断学]