医务人员与SARS患者免疫指标的对比研究

目的 :研究严重急性呼吸道综合征 (SARS)病毒对医务人员免疫功能可能产生的影响 ,为传染病的防治提供理论依据。方法 :采用胶体金法和ELISA法检测SARS患者 (SARS患者组 )及与患者密切接触的医务人员 (小汤山医院组与非SARS定点医院组 )血清中SARSIgG抗体含量 ,并用特种蛋白分析仪测定CRP、补体C3、C4及CIC含量 ,同时选取 13例正常人作为对照组。结果 :对照组血清SARSIgG抗体均阴性 ;非SARS定点医院组医务人员血清中 ,胶体金法 1例阳性 ,ELISA法 1例阳性 ,阳性率为 1 14 % ;SARS患者组IgG抗体均阳性 ,阳性率 10 0 %。SARS患者组CRP分别是对照组、非SARS定点医院组、小汤山医院组的 3 1倍、3 5倍和 2 8倍(P <0 0 1)。与对照组比较 ,非SARS定点医院组补体C3、C4下降了 2 5 2 0 %和 2 7 5 9% ,小汤山医院组补体C3下降了 13 3 9% (P <0 0 5 )。非SARS定点医院组补体C3、C4与小汤山医院组比较 ,分别下降了 13 64 %和 2 2 2 2 % (P <0 0 5 ) ,CIC含量增高了 2 0 0 2 % (P<0 0 5 )。结论 :SARS可能存在隐性感染 ,CRP与患者的临床症状相关 ,可作为SARS病情监测的指标 ;而病毒对医务人员免疫功能的影响显示 ,小汤山医院组小于非SARS定点医院组 ,表明小汤山医院的隔离防护体系较为完善

Comparative study on immunological parameters in SARS patients and in medical personnel

Objective:To investigate the potential impact of SARS virus on immunological function in medical personnel who had close contact with SARS patients and further to provide theoretical basis for prevention and treatment of the disease.Methods:Colloidal gold assay (CGA) and ELISA were adopted to detect antibody IgG against SARS virus in SARS patients and the medical personnel who had kept close contact with these patients at a SARS special hospital as well as a non-special SARS hospital.Moreover,Special Protein Analyzer was used to measure levels of C-reactive protein (CRP),complement component 3 and 4 (C3,C4) and circulating immune complex (CIC) in the SARS patients and the medical personnel.Thirteen normal subjects were selected as controls to undergo the same tests.Results:In controls,no specific IgG antibody against SARS virus was detected;in the medical personnel from the non-special hospital,specific antibody against SARS virus was found in one person by CGA and one by ELISA with a positivity of 1.14%.The 11 patients with SARS were all positive for specific antibodies against SARS virus and the positivity was 100%.The CRP level in the SARS patients was as much as 3.1 times,3.5 times and 2.84 time higher than in controls,medical personnel from the non-special hospital and from the the special SARS hospital (Xiaotangshan Hospital) with a significant difference (P<0.01).Compared with the controls,the concentrations of C3 and C4 in medical personnel from the non-special hospital were decreased by 25.2% and 27.59%,respectively,while C3 dropped by 13.39% in the personnel from Xiaotangshan Hospital (P<0.05).When compared with those in the personnel from Xiaotangshan,C3 and C4 were reduced by 13.64% and 22.22% respectively;there was a significant difference between the two groups of medical personnel;CIC concentration was increased by 20.02% (P<0.05).Conclusions:Silent SARS virus infection might be present.CRP was related with the clinical symptoms of the infection and it might serve as a indicator for monitoring the SARS patient's condition.The results of immunological function in the medical personnel shown that immunoreaction in those from Xiaotangshan Hospital was slighter than from the general hospital,indicating that Xiaotangshan Hospital was very well equipped with a isolation and protective system.