北京市某综合医院医务人员SARS-CoV-2感染后RBD中和抗体的变化特征  

Change of RBD neutralizing antibody in health care workers infected with SARS-CoV-2 in a general hospital of Beijing

作　　者：李锦[1] 张春燕[1] 彭薇 张民杰 姚宏武 杜明梅 刘运喜 周红辉[1] LI Jin;ZHANG Chun-yan;PENG Wei;ZHANG Min-jie;YAO Hong-wu;DU Ming-mei;LIU Yun-xi;ZHOU Hong-hui(Medical Innovation Research Division of Chinese PLA General Hospital,Beijing 1oo853,China;不详)

机构地区：[1]中国人民解放军总医院医学创新研究部出生缺陷防控技术研究中心,北京100853 [2]中国人民解放军总医院第一医学中心疾病预防控制科,北京100853

出　　处：《中华医院感染学杂志》2023年第10期1574-1578,共5页Chinese Journal of Nosocomiology

基　　金：国家重点研发计划(2020YFC2004604)。

摘　　要：目的分析感染新型冠状病毒(SARS-CoV-2)的医护工作人员特异性受体结合结构域(RBD)中和抗体变化,了解高风险人群免疫应答,为后续健康随访提供依据。方法随机选取2022年12月1日-2022年12月25日某综合医院385例感染SARS-CoV-2在岗医护工作人员,收集流行病学史和临床症状信息,检测末梢血SARS-CoV-2特异性抗体[S-IgM、S-IgG和RBD中和抗体(荧光免疫层析法)]表达水平,JPR模型分析表达趋势。结果JPR模型分析显示,S-IgM、S-IgG和RBD中和抗体分别在出现症状后4天、6天和6天上升趋势明显,S-IgM在出现症状后8天开始下降。广义线性混合模型多因素分析显示,性别和发热症状均与RBD中和抗体关联性弱;随着年龄增加,RBD中和抗体表达下降;接种疫苗会增加RBD中和抗体表达。结论SARS-CoV-2特异性抗体S-IgM、S-IgG和RBD中和抗体在出现典型症状后4~6天升高趋势明显,RBD中和抗体维持时间长。此外,随年龄增加,RBD中和抗体水平呈下降趋势。OBJECTIVE To observe the change of receptor binding domain(RBD)neutralizing antibody in health care workers infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and understand the immune response of high-risk population so as to provide evidence for follow-up.METHODS From Dec 1,2022 to Dec 25,2022,totally 385 health care workers who were infected with SARS-CoV-2 were recruited from a general hospital.The epidemiological data and clinical symptoms were collected,the expressions of SARS-CoV-2 specific antibodies[S-IgM,S-IgG and RBD neutralizing antibody(gold immunochromatography assay)in peripheral blood were detected,and the expression trends were analyzed by JPR model.RESULTS JPR model analysis showed that the expression levels of S-IgM,S-IgG and RBD neutralizing antibody were remarkably elevated after symptoms emerged for 4 and 6 days,the expression level of S-IgM began to decline after symptoms emerged for 8 days.The multivariate analysis based on generalized linear mixed model indicated that there was correlation between gender,fever and RBD neutralizing antibody,the expression level of RBD neutralizing antibody declined with the increase of age;vaccination could increase the expression of RBD neutralizing antibody.CONCLUSION The SARS-CoV-2 specific antibodies S-IgM,S-IgG and RBD neutralizing antibody are elevated remarkably after the typical symptoms emerge for 4-6 days,RBD neutralizing antibody maintains a certain level for a long time period.The RBD neutralizing antibody shows a downward trend with the increase of age.

关 键 词：新型冠状病毒 新型冠状病毒感染 特异性受体结合结构域 抗体 中和活性 流行病学 

分 类 号：R181.32[医药卫生—流行病学]