SARS患者血清特异性抗体的检测及临床诊断意义

目的 :评估临床诊断SARS患者血清特异性抗体产生规律对疾病诊断的意义。方法 :随机选取不同病程临床诊断为SARS的患者 15 6例 ,通过酶联免疫吸附的方法分别检测患者血清中特异性IgG型和IgM型抗体水平 ,分析SARS特异性抗体的产生与疾病病程的关系及对临床诊断的意义。结果 :血清IgG型抗体阳性 118例 ,阳性率为 75 .6 %。IgM型抗体阳性 6 5例 ,阳性率为 4 1.7%。IgG、IgM均为阴性 37例 ,占 2 3.7%。IgG型抗体产生阳性率随病程延长而逐渐增高 ,病程为 5 0～ 6 0d组阳性率最高达到了 94 .5 %。IgM型抗体阳性率也随病程延长而逐渐增高 ,但在病程 4 0～ 5 0d抗体阳性率即达最高 ,随后迅速下降。IgG与IgM抗体阳性率在其各自不同病程差异均十分显著 (P <0 .0 1)结论 :SARS患者血清特异性抗体检测可以作为SARS临床诊断的重要参考指标 ,但目前尚不宜作为诊断的金标准 ,SARS特异性IgG、IgM抗体同为阴性不能完全排除SARS诊断

Determination of specific antibodies in the sera of SARS patients and its clinical diagnostic significance

Objective:To evaluate clinical diagnostic significance of sera specific antibodies in severe acute respiratory syndrome (SARS) patients. Methods:Using ELISA,we determined sera coronavirus-specific IgG / IgM antibodies in 156 SARS patients and analysed the relation between the produce of specific antibodies and the courses of disease. Results:Positive rate of serum IgG antibody was 75.6%(118/156),and that of serum IgM antibody was 41.7%(65/156). There were 37 cases of negative sera specific antibodies with both IgG and IgM(23.7%). Positive rate of serum IgG and IgM antibodies rised with the prolong of the courses of disease,but IgG antibodies reached the culmination(94.5%) during the 50th to 60th day of the courses of disease, so did IgM antibody during the 40th to 50th day of the courses of disease. The difference of antibody positive rate was greatly significant in different courses of disease(P<0.01). Conclusions:Determination of sera specific antibodies in SARS patients may be a kind of important diagnostic reference index,but not golden standard at present. Negative cases of both IgG and IgM antibodies can`t be absolutely eliminated the diagnosis of SARS.