【摘要】 目的探讨血清抗SARS-CoV特异性LgG、lgM;外周血单核细胞、漱口液以及粪便SARS-CoV特异性套式RT-PCR检测SARS-Cov RNA在SARS确诊中的意义,并通过研究其系列标本,进一步探讨SARS-Coy特异性IgG、IgM出现规律及病毒传播规律。方法临床诊断SARS患者28例。1周采集2次血清、大便及漱口液系列标本。ELISA测定血清抗SARS-CoV特异性lgG、lgM,套式RT-PCR检测外周血单核细胞、漱口液以及粪便SARS-CoV RNA。结果血清SARS-COV-lgM阳性率为50％(14/28);SARS-COv-lgG阳性率为78.6％(22/28)。早期(-10天)lgG可出现;4周阳性率最高;lgG出现晚(11天-)。2-3周阳性率最高;持续时间短(11天-),4周后大部分患者阴转。PBMC SARS-COVRNA阳性率为32.1％(9/28),病程10-14天阳性率最高;漱口液SARS-COVRNA阳性率为57.1％(16/28),大便SARS-COVRNA阳性率为60.7％(17/28);病程2-3周阳性率最高。85.7％(24/28)可确诊SARS;14.3％不能确诊SARS。结论 SARS诊断必须加入病原学诊断标准。而且必须结合特异性抗体、外周血单核细胞、漱口液以及大便SARS-CoV RNA检测,综合判断。由于SARS患者特异性抗体出现晚等特点。因此,SAPS特异性抗体不能作为早期诊断。SARS患者病程2-3周传染性可能最强,而早期(10天内)传染性可能弱。更多还原

【Abstract】 Objective To investigate the duagnositc value of antil - SARS - CoV special IgG、IgM antibodies, SARS- CoV special Nest RT- PCR using peripheral blood monocvte (PBMC), gargle, and stool.The law of SARS- CoV transmission was also studied.Methods 28 SARS patients Who were treated in Beijing You’ an hospital on May 24th were investigated. For each patient, blood was taken for anti-SARS -CoV IgG and IgM antibodies. PBMC was taken for SARS -CoV Nest RT-PCR.GargU and stool were taken consequently on May 16th, 20th, and 23td and analysised by RT- PCR.For each sample, Nest RT- PCR were carried out simultaneously using7 - pair diffrent primers.Results The positive rate of anti -SARS- CoV IgG and IgM examined by GBI was 78.6% (22/28) and 50.0% (14/28), respectively. The postive of serum anti - SARS IgG and IgM were observed withiln 10 days.The highest positive rate was also observed on 3 -4 week. However, serum anti -SARS IgG, IgM obliteration were observed after 2 months , 11days. The positive rate of SARS -CoV special nest RT- PCR in PBMC, gargle, and stool was32.1% (9/28), 57.1% (16/28), and 60.7% (17/28) respectively.The highest positive rate was also observed on 2-3 weeks If anti -SARS- CoV IgG, IgM antibodies, nest RT - PCR in PBMC, gargle, and stool were considered in the SARS diagnostic marks. The SARS was confirmed if more than 2 positive results in these SARS- CoV assays. 85.7%of those SARS patients could be confirmed .Conclusions SARS- CoV etiological assay must be added in present SARS criteria.Anti - SARS - CoV antilbodies, nset RT- PCR using PBMC, gargle, and stool shoud be carried out simultaneously.Nest RT- PCR using gargle and stool shoud be repeated at least 3 times in the interval of 3 days under the condition of negative results.Tow positive results using different samples was a strong evident of SARS - CoV infection.The serum anti -SARS-CoV IgG and IgM can not be regarded as early diagnostic mark.The highest SARS-CoV transmission may be signifcanted.However, Thelower SARS- CoV transmission is considered with in 10 days.更多还原