摘要
探讨严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARSCoV-2)免疫球蛋白M(Immunoglobulin M,IgM)/免疫球蛋白G(Immunoglobulin G,IgG)、病毒核酸和白细胞介素6(interleukin 6,IL-6)的联合检测在2019冠状病毒病(coronavirus disease 2019,COVID-19)诊断和治疗中的临床价值。本研究按照《新型冠状病毒肺炎诊疗方案(试行第七版)》的标准收集了93例确诊病例(51例危重型、18例重型,15例轻型和9例普通型)和20例疑似病例(核酸检测阴性但临床症状和CT检测结果均符合标准)。选取110例儿科、妇科、肿瘤、血液和消化等疾病患者并排除COVID-19作为对照组。采用全自动化学发光免疫分析技术和电化学发光技术检测所有研究对象血清中SARS-CoV-2IgM/IgG和IL-6。用实时荧光定量反转录聚合酶链反应对病例组和对照组的咽拭子进行SARS-CoV-2核酸检测。结果发现,血清IgM、IgG和IL-6在疑似病例中的阳性率分别为85%、75%和0%,在确诊病例中的阳性率分别为98.9%、95.7%和75.2%(其中危重型分别为100%、100%和100%,重型分别为94.4%、100%和97.9%,轻型分别为100%、93.3%和5%、普通型分别为100%、66.7%和0%)。IL-6和SARS-CoV-2IgM/IgG表达水平的改变与患者疾病的严重程度存在一定的关联性,差异有统计学意义(χ^2=273.51,χ^2=149.37;P<0.05)。血清IL-6和SARS-CoV-2IgM/IgG的联合检测可作为诊断和治疗COVID-19的监测指标,也可作为SARS-CoV-2核酸检测假阴性的有效互补。
This article aims to explore the combined detection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)immunoglobulin M(IgM)/immunoglobulin G(IgG),viral nucleic acid and interleukin 6(IL-6)in the diagnosis and treatment of coronavirus disease in 2019(COVID-19).This study collected 93 patients(51 critical,18 severe,15 mild and 9 normal)according to the standard of"New Coronavirus Pneumonia Diagnosis and Treatment Plan(Version 7)"and 20 suspected cases(negative nucleic acid test but clinical symptoms and Ct test results met the standards).110 patients with other diseases such as pediatrics,gynecology,tumors,blood and digestion illness were selected as the control group.Automatic chemiluminescence immunoassay technology and electrochemiluminescence technology was used to detect2019-nCoV IgM/IgG and IL-6 in the serum of all subjects.Real-time fluorescence quantitative reverse transcription polymerase chain reaction was used to detect SARS-CoV-2 nucleic acid in pharyngeal swabs of case group and control group.The results showed that the positive rates of serum IgM,IgG and IL-6 in suspected cases were 85%,75%and 0%,respectively,and the positive rates in patients diagnosed with 2019 coronavirus were 98.9%,95.7%and 75.2%,respectively(Among them,critical cases are 100%,100%and 100%,severe cases are 94.4%,100%and 97.9%,mild cases are 100%,93.3%and 5%,and common types are 100%,66.7%and 0%).The changes of IL-6 and 2019-nCoV IgM/IgG expression levels were related to the severity of the patients’disease,and the differences were statistically significant(χ^2=273.51,χ^2=149.37;P<0.05).The combined detection of serum IL-6 and 2019-nCoV IgM/IgG can be used as a monitoring indicator for the diagnosis and treatment of new coronavirus infection,and can also be used as an effective complement to the false negative detection of SARS-CoV-2 nucleic acid.
作者
薛晓婕
陈美周
张常亮
汪宏良
XUE Xiaojie;CHEN Meizhou;ZHANG Changliang;WANG Hongliang(Affiliated Hospital of Hubei Polytechnic University,Huangshi Central Hospital,Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention,Huangshi 435000,Hubei Province,China)
出处
《微生物与感染》
2020年第4期228-232,共5页
Journal of Microbes and Infections
基金
湖北省卫生健康委联合基金项目(WJ2019H449)
湖北省医学青年拔尖人才计划。
