新型冠状病毒感染者血清中和抗体检测及临床意义  

Analysis of serum neutralizing antibodies in patients with COVID-19 and its clinical significance

作　　者：许怡[1] 许恒 郭云[1] 黄颖 高鹏 胡倩 高会霞[1] Xu Yi;Xu Heng;Guo Yun;Huang Ying;Gao Peng;Hu Qian;Gao Huixia(Laboratory Department,Fifth Hospital,Hebei Shijiazhuang 050021,China;School of Life Sciences,Beijing University of Chinese Medicine,Beijing 100105,China)

机构地区：[1]河北省石家庄市第五医院检验科,河北石家庄050021 [2]北京中医药大学生命科学学院,北京100105

出　　处：《新发传染病电子杂志》2023年第2期34-38,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：河北省医学科学研究课题(20221690)。

摘　　要：目的观察新型冠状病毒感染(COVID-19)患者血清抗SARS-CoV-2中和抗体水平的变化规律,为临床判断COVID-19患者的疾病进展及预后提供依据。方法选取2020年2月至2021年3月在石家庄市第五医院进行隔离治疗的COVID-19患者172例,分别收集患者感染早期(第1~7天)、中期(第8~14天)、后期(第15~21天)、恢复期(第22~41天)的血清样本,采用磁微粒化学发光免疫分析法检测抗SARS-CoV-2中和抗体。结果随着COVID-19患者病程进展中和抗体的阳性率逐渐升高,在感染后期达到峰值(90%以上感染者产生了中和抗体);中和抗体水平与感染天数之间有显著性相关(R=0.35,P<0.001);在感染早期,COVID-19无症状感染者血清中和抗体的阳性率及抗体水平均高于轻型、中型、重型患者,差异有统计学意义(P<0.05);感染后期和恢复期的患者,其中和抗体的阳性率及抗体水平随着病情的严重程度逐渐增加,差异有统计学意义(P<0.001)。在感染早期,<60岁组患者的血清中和抗体的阳性率及抗体水平均显著高于≥60岁组(P<0.05);在病程中后期及恢复期,<60岁组与≥60岁组患者的血清中和抗体的阳性率及抗体水平比较无显著性差异。结论COVID-19患者血清抗SARS-CoV-2中和抗体阳性率及抗体水平与疾病进程及患者病情严重程度密切相关。血清抗SARS-CoV-2中和抗体是评估COVID-19患者病情发展及预后的参考指标。Objective To analyze the levels of neutralizing antibody in the serum of patients infected with SARS-CoV-2,and to evaluate the severity and prognosis.Method In this study,172 COVID-19 patients who underwent isolation treatment at Shijiazhuang Fifth Hospital from February 2020 to March 2021 were selected,serum samples were collected from COVID-19 patients,including patients with early(1-7d),intermediate(8-14d),late(15-21d),and recovery(22-41d)stages of infection.The levels of SARS-CoV-2 neutralizing antibody were detected by magnetic particle-based chemiluminescence immunoassay.Result The positive rates of neutralizing antibody increased gradually with disease progression,peaking at 90%in the late stage of infection.The levels of SARS-CoV-2 neutralizing antibody were positively corrected with the length of infection(R=0.35,P<0.001).In early stage,the positive rates of neutralizing antibody were significantly higher in the asymptomatic infected persons than in the symptomatic patients(P<0.05),and the positive rates and levels of neutralizing antibody were significantly higher in patients<60 years old than in patients≥60 years old.In the late and recovery stages,the positive rates and levels of neutralizing antibody increased gradually with disease progression(P<0.001),and were not correlated with age.Conclusion The positive rates and levels of SARS-CoV-2 neutralizing antibody in serum were related with the severity of COVID-19 patients,and maybe an indicator for evaluating the prognosis.

关 键 词：新型冠状病毒感染 新型冠状病毒 中和抗体 磁微粒化学发光 

分 类 号：R511[医药卫生—内科学]