不同类型新型冠状病毒肺炎患者血清IgM、IgG动态变化特征分析  

Analysis of dynamic changes of serum IgM,IgG in patients with different types of COVID-19

作　　者：鲁雁秋 池祥波 王静[2] 孙凤 张露 陈耀凯[1] LU Yanqiu;CHI Xiangbo;WANG Jing;SUN Feng;ZHANG Lu;CHEN Yaokai(Department of Infectious Diseases,Chongqing Municipal Public Health Medical Treatment Center,Chongqing 400036,China;Department of Laboratory Medicine,Chongqing Municipal Public Health Medical Treatment Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心感染科,400036 [2]重庆市公共卫生医疗救治中心检验科,400036

出　　处：《重庆医学》2021年第18期3170-3173,共4页Chongqing medicine

基　　金：重庆市新型冠状病毒感染肺炎疫情应急科技攻关专项(cstc2020jscx-fyzx0005);重庆市公共卫生医疗救治中心青年科研创新基金(19QNKYXM09)。

摘　　要：目的分析并比较不同类型新型冠状病毒肺炎患者IgM、IgG动态变化特征,为新型冠状病毒肺炎患者的临床诊疗提供循证医学证据并辅助临床医生判断患者病情与病程。方法对105例新型冠状病毒肺炎住院患者的血清IgM与IgG检查结果进行分析,将患者分为无症状感染者、轻型/普通型和重型/危重型3种类型,分析比较不同类型患者在入院期间IgM与IgG的变化规律。结果入院时,105例新型冠状病毒肺炎患者的血清IgM阳性率为70.5%,IgG阳性率为74.3%。在4周的治疗期内,轻型/普通型患者血清IgM、IgG阳性率均在80.0%以上,重型/危重型患者血清IgM、IgG阳性率达100.0%,而无症状感染者血清IgM在入院时阳性率为56.1%,而后降低,到治疗4周时阳性率为14.3%。轻型/普通型和重型/危重型患者IgM、IgG阳性率在治疗后的第1、2周高于无症状感染者,差异有统计学意义(P<0.05)。轻型/普通型、重型/危重型和无症状感染者在入院时、治疗1、2、3、4周血清IgG、IgM滴度比较,差异有统计学意义(P<0.05)。重型/危重型患者血清IgM滴度在入院时、治疗后1、2、3、4周高于无症状感染者,IgG滴度在治疗后1、2、3、4周也高于无症状感染者,差异有统计学意义(P<0.05)。结论不同类型的新型冠状病毒肺炎患者血清IgM、IgG结果有所差异,血清抗体检测可作为核酸检测的重要补充,但不可单独用于疾病诊断和社区筛查。Objective Analyze and compare the dynamic changes of IgM and IgG in patients with different types of corona virus disease 2019(COVID-19),provide evidence-based medical evidence for the clinical diagnosis and treatment of patients with COVID-19,and assist clinicians in judging the patient′s condition and course of disease.Methods Serum IgM and IgG data of 105 hospitalized patients with COVID-19 were collected and analyzed,and the patients were divided into three types:asymptomatic,mild/common and severe/critical,to analyze and compare the IgM and IgG of different types of patients during admission.Results At the time of admission,among 105 patients with COVID-19,the positive rate of serum IgM was 70.5%and the positive rate of IgG was 74.3%.During the 4-week treatment period,the positive rate of serum IgM and IgG in patients with mild/common type was more than 80.0%,the positive rate of serum IgM and IgG in severe/critical patients reached 100.0%,the positive rate of serum IgM in asymptomatic patients at the time of admission was 56.1%,which decreased and reached 14.3%by 4 weeks of treatment.The positive rate of IgM and IgG in mild/common and severe/critical patients at the first and second weeks after treatment were significantly higher than those in asymptomatic infections,there was statistical significance(P<0.05).There were statistically significant differences in serum IgG and IgM titers in patients with mild/common,severe/critical and asymptomatic infections at the time of admission and 1,2,3 and 4 weeks of treatment(P<0.05).The serum IgM titers in severe/critical patients were higher than those in asymptomatic infections at admission and 1,2,3 and 4 weeks after treatment,while IgG titers were also higher at 1,2,3 and 4 weeks after treatment,the difference was statistically significant(P<0.05).Conclusion The results of serum IgM,IgG in different types of COVID-19 patients are different.Serum antibody testing can be used as an important supplement to nucleic acid testing,but cannot be used alone for disease

关 键 词：冠状病毒感染 肺炎 新型冠状病毒 新型冠状病毒肺炎 抗体 

分 类 号：R512.99[医药卫生—内科学]