新冠病毒感染者恢复期血清抗体水平及诊断价值  

Serum antibody level and diagnostic value in convalescent patients infected with novel coronavirus

作　　者：邢菲菲 冯欢欢 杜昱 魏丹 杜阳光[1] 童晶[1] Xing Feifei;Feng Huanhuan;Du Yu;Wei Dan;Du Yangguang;Tong Jing(Xuzhou Center for Disease Control and Prevention,Xuzhou 221006,China)

机构地区：[1]徐州市疾病预防控制中心,徐州221006

出　　处：《中华实验和临床病毒学杂志》2023年第4期404-409,共6页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的了解新型冠状病毒感染人群恢复期的血清抗体IgM、IgG、IgA和中和抗体(neutralizing antibodies,NAbs)水平及诊断意义。方法采用化学发光法检测感染者581例,未感染者219例,统计分析抗体阳性率和抗体水平,比较抗体之间有无相关性以及结合ROC曲线评估各抗体在接种人群中识别突破感染者的能力。结果感染者IgM、IgG、NAbs和IgA抗体滴度均高于未感染者。接种疫苗与未接种疫苗、不同年龄、不同剂次疫苗、接种疫苗不同间隔时间感染者抗体阳性率和抗体水平具有统计学意义(P<0.05);IgA抗体水平与IgG和NAbs呈正相关,NAbs和IgG抗体呈正相关;突破感染分析中,IgG、IgA和NAbs抗体识别接种人群中感染者能力较好。结论IgM抗体在病程恢复期的阳性率相对较低,对于新冠病程监测和疫苗效果评价意义较低。此外,接种新冠疫苗加强针可显著提高抗体水平及阳性率。IgG、IgA和NAbs抗体水平的差异可用于从接种人群中识别突破性感染病例。Objective To investigate the levels of serum IgM,IgG,IgA and neutralizing antibodies(NAbs)in convalescing patients infected with the novel coronavirus and their diagnostic significance.Methods Five hundreds and eighty one infected patients and 219 non-infected patients were detected by chemiluminescence method.The positive rate of antibody and antibody level were statistically analyzed for statistical significance.The correlation between the antibodies was compared,and the ability of each antibody to identify breakthrough infection in the vaccinated population was evaluated by combining ROC curve.Results The antibody titers of IgM,IgG,NAbs and IgA in infected patients were higher than those in uninfected individuals.The antibody positive rate and antibody level of infected persons who were vaccinated and not vaccinated,with different ages,different doses of vaccines,and different intervals of vaccination were statistically significant(P<0.05);IgA antibody levels were positively correlated with IgG and NAbs,and NAbs is positively correlated with IgG antibody;In breakthrough infection analysis,IgG,IgA and NAbs antibodies were good at identifying infected persons in the vaccinated population.Conclusions The positive rate of IgM antibody is low in the convalescence period,which is of little significance for monitoring the course of COVID-19 and evaluating the efficacy of vaccines.In addition,the antibody level and positive rate can be significantly improved by the booster injection of COVID-19 vaccine.Differences in IgG,IgA,and NAbs antibody levels can be used to identify breakthrough infection cases from vaccinated populations.

关 键 词：疫苗 新型冠状病毒 IGM IGG IGA 中和抗体 

分 类 号：R511[医药卫生—内科学]