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目的:观察新发传染病发热伴血小板减少综合征(SFTS)的病原体新型布尼亚病毒(SFTSV)核蛋白(NP)IgM和IgG型抗体在SFTS患者外周血中的变化规律,为疾病的早期诊断和发病机制的认识提供依据。方法:用ELISA方法检测28例SFTS患者不同病程阶段血清中NP特异性IgM、IgG抗体。结果:①28例SFTS患者中,IgM阳性检出率为89.3%(25/28),IgG阳性检出率为85.7%(24/28)。②IgM和IgG均在发病5天后开始出现,随着病程延长血清中抗体水平逐渐上升,其峰值出现在发病2周左右。③死亡组患者的抗体检出时间迟于痊愈组患者,且抗体水平低下。结论:①在SFTSV感染早期,SFTS患者血清中NP特异性抗体IgG和IgM的变化趋势一致,NP特异性抗体IgG和IgM一样是SFTS早期诊断的重要指标。②因疾病严重而死亡的患者,抗体出现延迟、抗体水平低下可能与患者细胞免疫系统严重受损及多脏器功能障碍有关,致使机体体液免疫应答减退或应答无能。③抗体出现延迟且抗体水平低下可能是病情严重患者预后不良的预测指标。
OBJECTIVE: To observe the regularity of the changes of SFTSV nucleoprotein (NP) IgM and IgG antibodies in the peripheral blood of SFTS patients with fever and thrombocytopenia syndrome (SFTS) Diagnosis and pathogenesis to provide the basis for understanding. Methods: Serum NP-specific IgM and IgG antibodies in 28 SFTS patients were detected by ELISA. Results: ①The positive rate of IgM was 89.3% (25/28) in 28 SFTS patients, and the positive rate of IgG was 85.7% (24/28). IgM and IgG began to appear 5 days after onset, with the course of the serum antibody levels gradually increased, the peak appeared in the onset of about 2 weeks. Antibody detection in patients of death group was later than that of patients in recovery group, and antibody level was low. CONCLUSIONS: ①In the early stage of SFTSV infection, the trend of NP-specific IgG and IgM in serum of SFTS patients is consistent. NP-specific IgG and IgM are also important indicators for the early diagnosis of SFTS. ② due to serious illness and death of patients, antibody delay, low antibody levels may be related to patients with severe cellular immune system damage and multiple organ dysfunction, resulting in the body fluid immune response diminished or incompetent. ③ antibody delay and antibody levels may be poor prognosis of patients with poor prognosis indicators.