血清抗体检测在一起本地传播新冠肺炎聚集性疫情溯源调查中的应用  

Application of serum antibody testing in source tracing of a locally transmitted COVID-19 infection outbreak

作　　者：旷翠萍[1] 王恩运 李博生 李林涛[1] 陈伟红[1] 宋铁[3] 孔东峰[4] 叶秋燕[1] 王艳梅 张家儿 江仕清 陈戊申[1] 史蓉婕 KUANG Cui-ping;WANG En-yun;LI Bo-sheng;LI Lin-tao;CHEN Wei-hong;SONG Tie;KONG Dong-feng;YE Qiu-yan;WANG Yan-mei;ZHANG Jia-er;JIANG Shi-qing;CHEN Wu-shen;SHI Rong-jie(Luohu Center for Disease Control and Prevention,Shenzhen,Guangdong 518020,China;不详)

机构地区：[1]深圳市罗湖区疾病预防控制中心,广东深圳518020 [2]深圳市罗湖医院集团医学检验中心,广东深圳518003 [3]广东省疾病预防控制中心 [4]深圳市疾病预防控制中心

出　　处：《现代预防医学》2021年第22期4192-4196,共5页Modern Preventive Medicine

基　　金：国家自然科学基金面上项目(82041030);深圳市医疗卫生三名工程项目(SZSM201601062)。

摘　　要：目的在深圳市一起本地传播COVID-19聚集性疫情溯源调查中,对重点涉疫人群开展抗体检测,帮助明确疫情扩散范围,追踪可能的源头。方法采用流行病学调查、大数据手段锁定重点涉疫人群,除对其开展SARS-COV-2核酸检测外,采用化学发光法检测抗体,对阳性者进一步开展流行病学调查和中和抗体检测,判断其在疫情传播中的作用。结果该疫情的9名个案在病程中均检测到Ig M抗体、Ig G抗体阳性。5606名涉疫人员检测了抗体,26人阳性,初筛阳性率为0.47%,其中11人Ig G抗体阳性,15人Ig M抗体阳性;但中和抗体实验和核酸检测均阴性。3人曾经出现过呼吸道症状,均否认与深港货车司机、国外入境人员、冷冻进口货物和发热呼吸道病例接触史。某口岸附近小区阳性率高于其他场所,差异有统计学意义(χ^(2)=8.29,P=0.004)。结论通过核酸和抗体检测结果可判断,本起疫情传播范围较为局限;化学发光抗体检测法有一定假阳性率,可以作为新冠肺炎疫情溯源调查的辅助方法,对有流行病学史的涉疫人员进行筛查,但不宜对一般人群进行大规模筛查。Objective To conduct antibody testing on key populations involved in a locally transmitted COVID-19 aggregated outbreak in Shenzhen to help clarify the spread of the outbreak and trace the possible source in a retrospective investigation.Methods Epidemiological investigation using big data was conducted to target the key outbreak-involved population.In addition to SARS-COV-2 nucleic acid testing,antibody testing was performed by chemiluminescence,and further epidemiological investigation and neutralizing antibody testing were conducted for those tested positive to determine their role in the spread of the outbreak.Results In total nine cases in this outbreak were tested positive for IgM and IgG antibodies.A total of 5 606 persons involved in the outbreak were tested for antibodies and 26 of them were positive,with a primary screening positive rate of 0.47%,including 11 positive for IgG antibodies and 15 positive for IgM antibodies;however,neutralizing antibody tests and nucleic acid tests were negative.Three persons had respiratory symptoms and all denied any association with the drivers of Shenzhen and Hong Kong trucks,the foreign arrivals,frozen imported goods and history of contact with febrile respiratory cases.The positive rate in the neighborhood of a port was higher than other sites,and the difference was statistically significant(χ^(2)= 8.29,P=0.004).Conclusion It can be judged based on the results of nucleic acid screening and antibody testing that the spread of this outbreak is limited.The chemiluminescent antibody assay has a certain false positive rate and can be used as an auxiliary method for the traceability investigation to screen individuals with an epidemic history,but not as a large-scale screening tool for the general population.

关 键 词：新型冠状病毒肺炎 溯源调查 抗体检测 化学发光免疫分析法 

分 类 号：R563.1[医药卫生—呼吸系统]