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目的了解SARS冠状病毒(SARS-CoV)感染者血清中特异性IgM、IgG抗体和两个结构蛋白抗体的持续时间及相互关系。方法对146例SARS临床确诊且血清抗-SARS-CoV阳性病例,随访采集发病当日至发病后660d期间的血液标本共362份。以ELISA法分别检测抗-SARS-CoVIgM和IgG抗体、SARS-CoVN蛋白和S蛋白IgG抗体。结果抗-SARS-CoVIgM阳性率在发病20d内为46.5%(20/43),21～40d阳性率最高(80.6%,25/31),尔后逐渐下降,至发病后500d左右仅为8.2%(6/73)。IgG总抗体在发病20d内阳性率(34.9%,15/43)低于IgM抗体,在发病21～40d迅速达到100%,至发病后600～660d,其阳性率仍高达98.6%(70/71)。N-IgG抗体在发病40d后阳性率(92.5%,37/40)高于S-IgG(67.5%,27/40),在61～90d、450～510d和600～660d3个时间点检测阳性率均高于S-IgG抗体;但两种结构蛋白抗体阳性率随时间延长均逐渐下降,两者于不同时间点的阳性率均低于抗-SARS-CoV总IgG。结论临床与病原学确诊的SARS患者,SARS-CoV特异性抗体阳性率在21～40d达高峰,IgG抗体阳性率100%。IgM抗体91.8%在感染500d以内消失;感染后两年IgG总抗体阳性率仍高达98.6%,推测可持续阳性3～5年。N-IgG和S-IgG抗体持续时间可能较短。
Objective To understand the duration and correlation of serum IgM, IgG antibodies and two structural protein antibodies in SARS-CoV infected patients. Methods A total of 362 cases of SARS-CoV-positive cases diagnosed by SARS were collected from the day of onset to 660 days after the onset of disease. Anti-SARS-CoVIgM and IgG antibodies, SARS-CoVN protein and S protein IgG antibody were detected by ELISA. Results The positive rate of anti-SARS-CoVIgM was 46.5% (20/43) within 20 days of onset and the highest positive rate (80.6%, 25/31) between 21 and 40 days, then decreased gradually to only about 500% after the onset of disease 6/73). The positive rate of IgG antibody was lower than that of IgM antibody within 20d after onset, reaching 100% within 21-40 days of onset and up to 98.6% (70/71) after 600-660 days of onset ). The positive rate of N-IgG antibody after 40 days of onset was higher than that of S-IgG (92.5%, 37/40), and the positive rate of N-IgG antibody was detected at 61-90 days, 450-510 days and 600-660 days Were higher than that of S-IgG antibody. However, the positive rates of the two structural proteins decreased gradually with time, the positive rates of the two antibodies were all lower than those of anti-SARS-CoV IgG. Conclusions The positive rate of SARS-CoV-specific antibodies in SARS patients diagnosed clinically and etiologically reaches the peak from 21 to 40 days, and the positive rate of IgG antibody is 100%. 91.8% of IgM antibody disappeared within 500 days after infection. The total positive rate of IgG antibody was still up to 98.6% two years after infection, suggesting a sustainable positive 3-5 years. The duration of N-IgG and S-IgG antibodies may be short.