【摘要】 目的 探讨严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染患者的抗体水平与上呼吸道病毒载量的关系。方法 收集2021年1月8日-9月21日由深圳市疾病预防控制中心确诊的47例SARS-CoV-2核酸阳性且无新型冠状病毒疫苗接种史患者的111份血清样本，根据患者确诊当日的病毒核酸检测循环阈值结果（Ct），将其分为两组：高病毒载量组（Ct<30）24例和低病毒载量组（Ct≥30）23例。利用化学发光法检测患者血清中SARS-CoV-2特异性免疫球蛋白（Ig）M、IgA、IgG、总抗体和中和抗体的水平。结果 89.4%的患者在感染SARS-CoV-2后可以产生相应的特异性抗体。在确诊后第1周，高病毒载量组的抗体阳性率均低于低病毒载量组（IgM:3.8%vs. 44.4%;IgA:7.6%vs. 34.6%;IgG:11.5%vs. 66.7%；总抗体：7.7%vs. 61.5%；中和抗体：18.2%vs. 76.9%），差异均有统计学意义（χ2=11.793、5.650、16.826、16.448、16.448,P均<0.05）。高病毒载量组的SARS-CoV-2 IgM、IgA、IgG、总抗体及中和抗体的浓度随病毒感染时间的增加呈明显上升趋势，而低病毒载量组则基本持平或略微下降。IgG浓度与中和抗体浓度成正相关（r=0.916,P<0.05）。结论 大多数患者会在病毒感染中后期产生新冠特异性抗体，患者确诊早期的核酸检测Ct值与其体内的抗体水平成负相关，IgG抗体检测是判断病毒感染进程及评估中和抗体水平的良好辅助手段。更多还原

【Abstract】 Objective To investigate the relationship between the antibody level and the viral load of the upper respiratory tract in patients infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). Methods A total of 111serum samples collected from 47 SARS-CoV-2 positive cases without vaccination in Shenzhen Center for Disease Control and Prevention from January 8 to September 21,2021. According to the cycle threshold(Ct)values of viral nucleic acid detection on the day of diagnosis,the patients were divided into two groups:high viral load group(Ct<30)(n=24)and low viral load group(Ct≥30)(n=23). The levels of immunoglobulin(Ig)M,IgA,IgG,total antibody and neutralizing antibody against SARS-CoV-2 were detected with chemical luminescence method. Results About 89.4% of the patients were positive for the specific antibodies after SARS-CoV-2 infection. In the first week after the patients were diagnosed,the positive rate of IgM,IgA,IgG,total antibody and neutralizing antibody of SARS-CoV-2 in the high viral load group were lower than those in the low viral load group(IgM:3.8% vs. 44.4%;IgA:7.6% vs. 34.6%;IgG:11.5% vs. 66.7%;total antibody:7.7%vs. 61.5%;neutralizing antibody:18.2% vs. 76.9%),and the differences were statistically significant（χ2=11.793,5.650,16.826,16.448,16.448;all P<0.05）. The concentrations of IgM,IgA,IgG,total antibody and neutralizing antibody against SARS-CoV-2 in the high viral load group increased significantly with the time of infection,while these antibodies in the low viral load group remained unchanged or slightly decreased. IgG was positive related with the concentration of neutralizing antibody(r=0.916,P<0.05). Conclusions Most patients were positive for SARS-CoV-2 specific antibodies.The Ct values of nucleic acid detection in patients were negatively correlated with the antibody level in the early stage after diagnosis. IgG antibody detection was a good auxiliary method to judge the course of virus infection and evaluate the level of neutralizing antibody.更多还原