SARS病毒基因和特异性抗体检测效果评估

目的 :评估严重急性呼吸综合征 (SARS)病毒基因检测和特异性抗体检测效果。方法 :采用巢式反转录PCR检测健康人、普通发热患者、不同时期 SARS患者痰标本中的 SARS病毒核酸即 RNA;采用酶联免疫吸附试验(EL ISA)法检测上述几组血清标本中的特异性抗体 Ig G和 Ig M。结果 :SARS患者住院 6 d～ 5 7d期间 ,采用巢式 RT-PCR检测痰 SARS病毒基因 ,5 6例患者中 34例阳性 ,阳性率 6 0 .7% ;而采用间接 EL ISA检测血清抗 SARS病毒抗体 ,5 6例患者中 32例阳性 ,阳性率为 5 7.1%。两种方法均阳性的有 15例 ,均阴性的有 6例。2种病原学诊断方法检测2 0例正常人和 15例发热非 SARS患者 ,结果均为阴性。住院 6 d～ 13d组 (92 .3% )巢式 RT- PCR基因阳性率明显高于 EL ISA特异性抗体阳性率 (7.7% ) ;住院 >35 d组巢式 RT- PCR基因阳性率 (36 .8% )则明显低于 EL ISA特异性抗体阳性率 (94 .7% ) (P<0 .0 1)。结论 :痰中 SARS病毒基因检测可用于 SARS的早期诊断 ,这对于提前确诊和治疗SARS患者 ,以及尽早排除疑似病例具有非常关键和现实的意义。血清特异性抗体检测可用于流行病学调查 ,但对SARS早期诊断和鉴别没有意义。

An Evaluation on Detecting the Specific Antibody and SARS-cov Gene of SARS Patients

Objective To assess the effect of detecting the specific antibody and the SARS-cov gene of SARS patients. Methods The specific IgG and IgM antibody in the serum of the SARS patients in different period , the healthy and feverous patients without SARS were detected by ELISA ;the SARS-cov RNA in the sputum of these groups’ were detected by nested RT-PCR. Results During 6 days～57 days of hospitalization , the SARS-cov gene in the sputum of 56 SARS patients were detected by nested RT-PCR, 34 of 56 cases are positive, and the positive rate is 60.7 %; the specific antibodies in 32 of 56 cases are positive by indirect ELISA, and the positive rate is 57.1 %.15 Cases are positive and 6 cases are negative by two pathogen diagnostic methods. 20 Cases of the healthy and 15 cases of general fever patients are all negative by two pathogen diagnostic methods. during 6 days～13 days of hospitalization, the positive rate of SARS-cov RNA in the sputum of SARS by the nested RT-PCR(92.3 %) is markedly higher than that of the specific antibodies in the serum of the SARS patients by the indirect ELISA(7.7 %); during >35days of hospitalization, the positive rate of SARS-cov RNA in the sputum of SARS by the nested RT-PCR(36.8 %) is markedly lower than that of the specific antibodies in the serum of the SARS patients by the indirect ELISA(94.7 %)(P<0.01).Conclusion The early SARS patients could be diagnosed by detecting the SARS-cov gene in the sputum of SARS patients. It is of practical significance for diagnosing and curing the SARS patients and excluding the suspicious cases early. It is of limited sense for diagnosis and identification of SARS to detect the specific antibody in the serum of SARS patients.