SARS 25例临床诊断患者血浆特异性抗体和病毒的动态检测

目的 动态检测SARS患者血浆特异性IgM和IgG以及SARS冠状病毒(SARS-CoV)的变化规律。方法 用酶联吸附免疫法对25例145份SARS临床诊断患者血浆特异性IgM和IgG进行定性检测，用RT-PCR对其中114份血浆进行SARS-CoV定性检测。结果 IgM和IgG抗体的阳性样本检出率分别为49．0％(71／145)和54．5％(79／145)，阳性患者检出率均为84．0％(21／25)，两种抗体大多在发病第2～4周产生，前5周检出率相近，均呈上升趋势，以后IgM抗体检出率开始下降，IgG抗体检出率则继续上升。血浆SAPS-CoV阳性样本检出率为15．8％(18／114)，阳性患者检出率为40．0％(10／25)，多为发病后4周内采集的样本，抗体检测阴性或初次阳性。结论 血浆特异性抗体以及SARS-CoV检测可作为SARS的确诊依据；抗体产生后大多数病人血浆病毒很快转阴，但有个别病人在抗体产生2～3周后仍能在血浆中检测到病毒序列。

Dynamic analysis of anti-Cov antibody and SARS coronavirus in the plasma of 25 SARS patients

Objective To observe dynamic responsive regularity of specific IgM and IgG antibodies in SARS patients. Methods 145 specimens of plasma from 25 cases of clinically diagnosed SARS patients were examined in the study. ELISA was employed to detect IgM and IgG antibodies against SARS coronaviral antigens. Nested RT-PCR was used to qualitatively determine SARS coronavirus (SARS-CoV). Results 49.0% (71/145) and 54.5% (79/145) of the samples were positive for IgM and IgG antibodies, respectively. Both antibodies were found to be detected in 84.0% of the patients. The antibodies were found to be detectable from the 2nd to 4th week after the onset of disease in most patients, and there was a fendeney of sising in positive rate until the 5th week after the onset. Thereafter, the detectable rate of IgM antibody began to decline, while that of IgG antibody remained to rise. Positive rate for serum SARS-CoV was 15.8% (18/114) for all samples or 40.0% (10/25) of patients. Most virus-positive samples were those which were collected within 4 weeks after disease onset. Conclusions Anti-SARS-CoV IgM/IgG antibody and detection of virus in plasma could serve as practical diagnostic indicators for SARS. In most cases, when the serum was pasitive for antibody the serum virus positive rate would soon declined. However, concomitant existence of antibody and viral sequence in plasma was observed in a few patients.