新冠肺炎患者特异性抗体IgM、IgG和病毒RNA的动态变化  

Dynamic characteristics of specific antibodies IgM, IgG and viral RNA in patients with COVID-19

作　　者：梁丽霞[1] 陈洪清[1] 林志芳[1] LIANG Li-xia;CHEN Hong-qing;LIN Zhi-fang(Department of Clinical Laboratory,the First People's Hospital ofZhaoqing,ZhaoQing,Guangdong 526060,China)

机构地区：[1]肇庆市第一人民医院检验科,广东肇庆526060

出　　处：《中国热带医学》2023年第1期58-63,共6页China Tropical Medicine

基　　金：肇庆市2020年科技专项(No.2020N7004)。

摘　　要：目的 研究新型冠状病毒感染患者IgM及IgG特异性抗体与新型冠状病毒核酸RT-PCR检测在住院期间的变化趋势。方法 将肇庆市第一人民医院收治的100例SARS-CoV-2感染住院患者根据是否接种疫苗分为疫苗组、无疫苗组。无疫苗组又分为重型、普通型及轻型和无症状组。监测所有患者住院0~<8 d、8~<15 d、15~<22 d、22~<29 d、29~<36 d及≥36 d的核酸检测结果和化学发光法测定的IgM和IgG抗体阳性率及S/CO值的动态变化趋势,比较不同组间的统计学差异。结果 疫苗组和无疫苗组,住院8~<15 d和≥36 d,IgM抗体阳性率分别为55.6%(15/27)和68.5%(50/73)、0(0/27)和49.0%(36/73),差异均有统计学意义(χ^(2)=11.048,20.805,P<0.05)。住院0~<8 d和8~<15 d,IgG抗体阳性率分别为96.3%(26/27)和45.2%(33/73)、100.0%(27/27)和78.1%(57/73),差异均有统计学意义(χ^(2)=21.268,7.576,P<0.05)。住院8~<15 d、15~<22 d、22~<29 d、29~<36 d。RNA阳性率分别为29.6%(8/27)和76.7%(56/73)、14.8%(4/27)和65.8%(48/73)、7.4%(2/27)和42.5%(31/73)、7.4%(2/27)和26.0%(19/73),差异均有统计学意义(χ^(2)=18.964,20.490,10.957,4.119,P<0.05)。在住院不同时期,疫苗组IgG抗体S/CO值均高于无疫苗组(P<0.05),而IgM抗体差异均无统计学意义(P>0.05)。重型患者的IgM抗体和IgG抗体在住院22~<29 d和29~<36 d的S/CO值均显著高于普通型、轻型及无症状组(F=17.694,15.116,4.037,4.115,均P<0.05)。结论 重型患者IgM和IgG抗体水平在康复过程中免疫防御的激活更大。在接种疫苗的情况下,IgM抗体在SARS-CoV-2感染后仍能很好地反应机体抵抗病毒的整个病程。Objective To study the changed trend of IgM and IgG specific antibody with chemiluminescent immunoassay(CLIA) and RT-PCR in SARS-CoV-2 infection patients during hospitalization.Methods A total of 100 hospitalized patients with SARS-CoV-2 infection who admitted to the First People’s Hospital of Zhaoqing were divided into vaccinated group and unvaccinated group according to whether they were vaccinated COVID-19 vaccine or not. The unvaccinated group was further divided into severe, normal, mild and asymptomatic groups. The nucleic acid test results, the positive rate of IgM and IgG antibodies measured by CLIA, and the dynamic trend of S/CO values of all SARS-CoV-2 infected patients since admission 0-<8 days, 8-<15days, 15-<22 days, 22-<29 days, 29-<36 days and≥36 days were monitored, and the statistical differences between different groups were compared.ResultsThe positive rate of IgM antibody in the unvaccinated group 55.6%(15/27)and 0(0/27) were all significantly higher than that in the vaccinated group 68.5%(50/73) and 49.0%(36/73) at 8-<15 days and ≥36 days of hospitalization(χ^(2)=11.048, 20.805, P<0.05). The positive rate of IgG antibody in the vaccinated group 96.3%(26/27) and 100%(27/27) were all significantly higher than that in the unvaccinated group 45.2%(31/73) and 78.1%(57/73) at0-< 8 days and 8-<15 days of hospitalization(χ^(2)=21.268, 7.576, P<0.05). The positive rate of RNA in the unvaccinated were all significantly higher than that in the vaccinated group at 8-<15 days 76.7%(56/73) and 29.6%(8/27), 15-<22 days 65.8%(48/73) and 14.8%(4/27), 22-<29 days 42.5%(31/73) and 7.4%(2/27), 29~<36 days 26.0%(19/73) and 7.4%(2/27) of hospitalization(χ^(2)=18.694,20.490, 10.957, 4.119, all P<0.05). The S/CO value of IgG antibody in the vaccinated group were all significantly higher than that in the unvaccinated group at differentperiods of hospitalization(t=2.841, 7.135, all P<0.05), but there was no significant difference in the S/CO value of IgM antibodyat different periods of hospitalization in pair

关 键 词：新型冠状病毒 RT-PCR IGM抗体 IGG抗体 化学发光免疫分析 新型冠状病毒疫苗 

分 类 号：R563.3[医药卫生—呼吸系统]