| 摘要: |
| 目的 研究新型冠状病毒肺炎(COVID-19)患者特异性抗体免疫球蛋白(Ig)M、免疫球蛋白(Ig)G及总抗体动态变化规律,评价应用化学发光在COVID-19诊断中的可靠性及诊断效能,并通过抗体血清学转化探讨普通人群筛查策略,为科学地防治COVID-19提供理论依据。方法 收集我院2020年1月25日至3月17日就诊患者89例,共计142份血清,其中16例确诊COVID-19患者的不同采血时间点共69份血清作为病例组,73例核酸阴性的排除患者共73份血清作为对照组。采用全自动化学发光免疫分析技术对收集血清进行新型冠状病毒(SARS-CoV-2)IgM、IgG和总抗体检测。结果 IgM检测的敏感度为40-58%(28/69),特异度为98.63%(72/73),符合率为70.42%(100/142);IgG检测的敏感度为89.86%(62/69),特异度为98.63%(72/73),符合率为94.37%(134/142);总抗体检测的敏感度为95.65%(66/69);特异度为98.63%(72/73);符合率为97.18%(138/142)。所有抗体在发病1周内检测阳性率较低,从第2周开始,抗体阳性率逐步升高。IgM抗体在第5周阳性率达70%的峰值,从第6周开始逐渐降低;IgG从第3周开始阳性率持续维持在100%,总抗体从第2周开始阳性率持续维持在100%。结论 化学发光法检测SARS-CoV-2抗体可作为COVID-19感染的有效筛查和诊断指标,相比较而言总抗体检测效能优于单独检测IgM或IgG。作为普通人群筛查时,抗体检测结果应进行动态监测及跟踪随访。 |
| 关键词: 新型冠状病毒 新型冠状病毒肺炎 化学发光法 免疫球蛋白M 免疫球蛋白G 总抗体 筛查策略 |
| DOI：10.16252/j.cnki.issn1004-0501-2021.01.018 |
| 分类号:R446.11 |
| 文章编号:1004-0501(2021)01-0078-04 |
| 文献标识码:A |
| 基金项目:四川大学华西医院新型冠状病毒肺炎疫情科技攻关项目(编号:HX-2019-nCov-050) |
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| Comparison of Diagnostic Efficiency of SARS-COV-2 Antibody Reagent Detected by Chemiluminescence Assay and Antibody Screening Strategies. |
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Deng Jielun, Wang Yuanfang, Ao Keping, Wu Zhongyang, Wu Siying, Li Dongdong, Xie Die
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Department of Experimental Medicine, West China Hospital, Sichuan University, Chengdu,Shichuan 610041 , China.
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| Abstract: |
| Objective To study the dynamic changes of specific antibodies, such as immunoglobulin(Ig)M, immunoglobulin(Ig)G and total antibody, in patients with COVID-19. To evaluate the reliability and efficacy of chemiluminescence in the diagnosis of COVID-19. In addition, screening strategie for the general population was discussed through antibody serological transformation, so as to provide theoretical basis for the scientific prevention and treatment of COVID-19. Method A total of 142 serum were collected from 89 patients who visited our hospital between January 25 and March 17, 2020. Among them, 69 serum , the case group, from 16 patients who confirmed as COVID-19 were collected at different time points, and 73 serum from 73 excluded patients with negative nucleic acid were used as the control group. SARS-COV-2IgM, IgG and total antibody were detected by novel chemiluminescence immunoassay.Result The sensitivity and specificity of IgM detection were 40.58%(28/69), 98.63%(72/73)and 70.42%(100/142)respectively. The sensitivity and specificity of IgG detection were 89.86%(62/69), 98.63%(72/73)and 94.37%(134/142)respectively. The sensitivity of total antibody detection was 95.65%(66/69).The specificity was 98.63%(72/73).The coincidence rate was 97.18%(138/142). The positive rate of all antibodies was low within 1 week of the onset, and increased gradually from the second week. The positive rate of IgM antibody peaked at 70% at week 5 and gradually decreased from week 6.The positive rate of IgG was maintained at 100% from the third week, and the positive rate of total antibody was maintained at 100% from the second week. Conlusion The detection of SARS-COV-2 antibody by chemiluminescence is an effective screening and diagnostic indicator for COVID-19 infection, and the detection efficiency of total antibody is better than IgM or IgG alone. When screening the general population, the antibody detection results should be dynamically monitored and followed up. |
| Key words: SARS-CoV-2 corona virus disease 2019 chemiluminescence immunoglobulin M immunoglobulin G total antibodies screening strategy |
