院内感染SARS医护人员特异性IgG抗体水平的影响因子

目的探讨院内感染严重急性呼吸道综合征(SARS)医护人员特异性IgG抗体水平的影响因素。方法回顾性收集20例院内感染SARS医护人员的人口特征、流行病学史、临床表现、实验室检查和主要治疗措施等资料作为研究因素,采用间接酶联免疫吸附试验(ELISA)检测20例SARS患者在发病后第1～36周的血清特异性IgG抗体。分类变量的研究因素比较不同结局患者之间抗体水平采用方差分析;通过一元线性回归、逐步回归分析和偏相关分析数值变量的研究因素与抗体水平之间的关系。结果SARS特异性IgG抗体水平在女性患者高于男性患者,结果有统计学意义(P=0.044);与患者在病程中的最高中性粒细胞计数呈中等程度负相关(偏相关系数=-0.636,P=0.008);与病毒唑治疗的总剂量呈高度正相关(偏相关系数=0.811,P=0.000)。结论SARS特异性IgG抗体水平的影响因素可能与病毒在体内被抑制、病毒血症的持续时间和患者发病后的中性粒细胞反应水平有关,SARS特异性IgG抗体水平与性别的关系值得进一步探讨。

Factors Affecting the Level of SARS Specific IgG in Medical Staffs with Nosocomial Infection of SARS

Objective To investigate the factors affecting the level of SARS virus specific IgG in medical staffs with nosocomial infection of SARS. Methods A retrospective review of medical treatments of 20 medical staffs with SARS of nosocomial infection was conducted. Epidemiological data and laboratory tests were also analyzed. The level of SARS IgG antibody was measured by ELISA method. Linear regression, stepwise multiple linear regression and partial correlation analysis were used in data analysis. Results The level of SARS IgG antibody was significantly higher in female patients than in male patients. The level of SARS IgG antibody showed a moderate negative correlation with the highest cell count of neutrophilic granulocyte during the course of the disease (partial correlation coefficient=-0.636,P=0.008), and a positive correlation with the high cumulative dose of Virazole in patients (partial correlation coefficient=0.811,P=0.000). Conclusion The level of the SARS specific IgG might be correlated with the in vivo inhibition of virus replication, the persisting time of viremia and the level of neutrophilic granulocytes in SARS patients. The correlation between production of SARS specific IgG and the sex of the patients needs further be investigated.