新型冠状病毒肺炎康复者特异性抗体的动态变化及临床意义  

Dynamic changes and clinical significance of COVID-19 specific antibodies in rehabilitated patients

作　　者：李幼霞 黄煌 蔡水江 刘莹[1] 刘勇进 梁桐 杜淑华 赖文娇 邓西龙 LI You-xia;HUANG Huang;CAI Shui-jiang;LIU Ying;LIU Yong-jin;LIANG Tong;DU Shu-hua;LAI Wen-jiao;DENG Xi-long(Department of Critical Care Medicine,Guangzhou Eighth People's Hospital affiliated to Guangzhou Medical University,Guangzhou,Guangdong 510060,China)

机构地区：[1]广州医科大学附属市八医院重症医学科,广东广州510060

出　　处：《中国热带医学》2022年第9期816-820,共5页China Tropical Medicine

基　　金：广东省防治新型冠状病毒科技攻关专项(No.2020B111105001);广州市卫生健康科技项目(No.20211AO10029)。

摘　　要：目的 探讨新型冠状病毒肺炎(COVID-19)康复者特异性抗体的动态变化及其临床意义。方法 本研究采用回顾性研究方法,收集2020年2月6日至2021年3月24日在广州医科大学附属市八医院随访的成人COVID-19康复者141例,根据出院时诊断分型将康复者分为重症组(重型及危重型)与非重症组(轻型及普通型)。对比分析两组患者在出院后1周、2周、1个月、3个月、6个月、1年随访的抗体变化情况。结果 重症组1周IgG阳性率为95.00%,随后1年均为100.00%;非重症组1周IgG阳性率为59.50%、6个月为90.08%、1年为76.03%。6个月随访重症组血清抗体IgG较非重症组明显升高,差异有统计学意义(Z=-2.441,P=0.015)。1年随访重症组血清抗体IgG较非重症组明显升高,差异有统计学意义(Z=-3.410,P=0.001)。重症组1年随访IgM水平较6个月明显降低,差异有统计学意义(Z=-2.259,P=0.024);非重症组1年随访时IgG、IgM水平较6个月明显降低,差异有统计学意义(Z=-7.370,P<0.01;Z=3.850,P<0.01)。结论 COVID-19康复者血清保护性抗体在出院后6个月内维持在较高水平,出院后1年内基本保持稳定。重症组抗体滴度较非重症组明显升高且持续时长至少1年。COVID-19康复者能获得1年的自然免疫保护能力,病情危重者获得的免疫持续时间更长久。ObjectiveTo investigate the dynamic changes and clinical significance of specific antibodies in patients with coronavirus disease 2019(COVID-19).Methods survivors who were followed up in the Eighth Hospital affiliated to Guangzhou Medical University from February 6, 2020, to March 24, 2021. The patients were divided into severe group(severe and critical) and non-severe group(light and ordinary)according to the diagnosis at discharge. The antibody changes of the two groups were compared and analyzed at 1 week, 2weeks, 1 month, 3 months, 6 months and 1 year after discharge.Results IgG in the severe group was 95.00% after 1 week and 100.00% in the following year, in the positive rate of IgG in the nonsevere group was 59.50% after 1 week, 90.08% in 6 months and 76.03% in one year. The level of serum IgG in the severe group was significantly higher than that in non-severe group(Z=-2.441, P=0.015). One-year follow-up: the serum IgG in the severe group was significantly higher than that in the non-severe group(Z=-3.410, P=0.001). The serum IgM level of the severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant(Z=-2.259,P=0.024). The serum IgG and IgM level of the non-severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant(Z=-7.37, P<0.01;Z=3.850, P<0.01).ConclusionThe level of serum protective antibody in COVID-19 patients remained high within 6 months after discharge, and remained stable within 1 year after discharge. The antibody titers in the severe group were significantly higher than those in the non-severe group and lasted for at least one year. COVID-19 survivors receive 1 year of natural immune protection, and patients with critical conditions receive immunity for longer periods of time.

关 键 词：新型冠状病毒肺炎 免疫球蛋白M 免疫球蛋白G 疫苗 中和性抗体 

分 类 号：R563.1[医药卫生—呼吸系统]