COVID-19患者5种标本的SARS-CoV-2核酸与血浆IgM抗体检测结果分析  

Analysis on the results of SARS-CoV-2 nucleic acid and plasma IgM antibody detection in 5 kinds of specimens of patients with COVID-19

作　　者：曾娅莉[1] 李明珍 蒲琴[1] 蒋正方 周云 邓建军[1] 蒋奕[1] 张旭[1] 杨洁 陈孝刚 马骥[1] ZENG Yali;LI Mingzhen;PU Qin;JIANG Zhengfang;ZHOU Yun;DENG Jianjun;JIANG Yi;ZHANG Xu;YANG Jie;CHEN Xiaogang;MA Ji(Department of Clinical Laboratory,Sichuan Mianyang 404 Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川绵阳四0四医院检验科,绵阳四川621000

出　　处：《检验医学与临床》2021年第11期1521-1524,1530,共5页Laboratory Medicine and Clinic

基　　金：四川省绵阳市科技局应急科研项目(2020YJKY010、2020YJKY012、2020YJKY013)。

摘　　要：目的分析不同标本类型与检测次数对新型冠状病毒(SARS-CoV-2)核酸检测结果的影响,评价SARS-CoV-2核酸与IgM抗体检测技术在新型冠状病毒肺炎(COVID-19)患者诊断中的应用。方法连续3次(每天1次)采集患者的痰、咽拭子、血液、唾液和晨尿标本,实时荧光定量逆转录聚合酶链反应(qRT-PCR)检测SARS-CoV-2核酸,同时检测患者血浆SARS-CoV-2 IgM抗体。对检测结果进行以下分析:1次与连续3次(每天1次)检测5种标本的SARS-CoV-2核酸阳性率;1次与连续3次(每天1次)检测SARS-CoV-2 IgM抗体的阳性率;连续3次检测5种标本的SARS-CoV-2核酸阳性率与SARS-CoV-2 IgM抗体检测的阳性率比较,以及两者联合应用对COVID-19患者的检出情况。结果1次检测5种标本SARS-CoV-2核酸,各标本的阳性率:痰46.66%,咽拭子40.00%,血浆13.33%,唾液33.33%,晨尿0;同种标本连续检测3次SARS-CoV-2核酸,各标本的阳性率:痰80.00%,咽拭子66.66%,血浆13.33%,唾液60.00%,晨尿0。1次与连续3次检测患者血浆SARS-CoV-2 IgM抗体的阳性率均为93.33%。血浆SARS-CoV-2 IgM抗体的阳性率明显高于SARSCoV-2核酸技术,两种方法联合对COVID-19的检出率为100.00%。结论SARS-CoV-2核酸检测阳性检出率与采集标本种类相关,多次多部位采集标本可明显提高SARS-CoV-2核酸阳性检出率。SARS-CoV-2 IgM抗体阳性检出率明显高于SARS-CoV-2核酸技术,两种方法联合可明显提高COVID-19的实验室检出率。Objective To analyze the effects of different specimen types and detection times on the detection results of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid,and to evaluate the application of SARS-CoV-2 nucleic acid and IgM antibody detection in the diagnosis of coronavirus disease 2019(COVID-19).Methods Sputum,throat swab,blood,saliva and morning urine samples were collected three consecutive times(once a day).SARS-CoV-2 nucleic acid was detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction(qRT-PCR),and SARS-CoV-2 IgM antibody in plasma was detected.The results were analyzed as follows:the positive rate of SARS-CoV-2 nucleic acid in 5 samples was detected once or three times a day.The positive rates of IgM antibody against SARS-CoV-2 were detected once and three times a day;compared the positive rates of SARS-CoV-2 nucleic acid and SARS-CoV-2 IgM antibody in five samples for the detection of three consecutive times,and the detection results of the combination of SARS-CoV-2 nucleic acid and SARS-CoV-2 IgM antibody in patients with COVID-19.Results The positive rate of SARS-CoV-2 nucleic acid was 46.66%in sputum samples,40.00%in throat swab samples,13.33%in plasma samples,33.33%in saliva samples and 0 in morning urine samples when detected once.The positive rate of SARS-CoV-2 nucleic acid was 80.00%in sputum samples,66.66%in throat swab sam-ples,13.33%in plasma samples,60.00%in saliva samples and 0 in morning urine samples when detected 3 times.The positive rate of plasma SARS-CoV-2 IgM antibody was both 93.33%when detected once or three consecutive times.The positive rate of plasma SARS-CoV-2 IgM antibody was significantly higher than that of SARS-CoV-2 nucleic acid.The detection rate of COVID-19 was 100.00%when the two methods were combi-nated.Conclusion The positive detection rate of SARS-CoV-2 nucleic acid was related to the types of sam-ples.The positive detection rate of SARS-CoV-2 nucleic acid could be significantly improved by multiple col-le

关 键 词：新型冠状病毒肺炎 新型冠状病毒 实时荧光定量PCR IGM抗体 

分 类 号：R446.9[医药卫生—诊断学]