严重急性呼吸综合征(SARS)临床排除病例与SARS病例心肌酶谱和体液免疫结果分析

目的 :分析 SARS临床排除病例与 SARS病例心肌酶谱和体液免疫的特征 ,为严重急性呼吸综合征( SARS)临床排除病例与 SARS病例的鉴别诊断提供依据。方法 :采用 ( IFCC)推荐方法、速率散射免疫比浊法和间接酶联免疫吸附实验 ( EL ISA)、双抗原夹心 EL ISA分别检测 18例 SARS临床排除病例和 4 5例 SARS病例入院第 2天血清天冬氨酸转氨酶 ( AST)、乳酸脱氢酶 ( L DH)、肌酸激酶 ( CK)、肌酸激酶同工酶 ( CK- MB)、羟丁酸脱氢酶 ( HBDH) ,血清免疫球蛋白 Ig G、Ig M、Ig A ,补体 C3、C4、C反应蛋白 ( CRP)的含量 ,以及血清抗 SARS病毒特异性抗体。结果 :SARS临床排除病例组 AST活力显著低于 SARS病例组 ( P<0 .0 5 ) ,L DH、HBDH活力也显著低于 SARS病例组 ( P<0 .0 1) ,CK、CK- MB活力与 SARS病例组无显著差别 ( P>0 .0 5 )。 SARS临床排除病例组 CRP含量显著低于 SARS病例组 ( P<0 .0 5 ) ,血清免疫球蛋白 Ig G、Ig M、Ig A,补体 C3、C4含量与 SARS病例组差异不显著 ( P>0 .0 5 )。间接 EL ISA检测 SARS临床排除病例特异性抗体 Ig G和 Ig M均为阴性 ,SARS病例组特异性抗体 Ig G阳性 32例 ,Ig M阳性 19例 ,累计阳性 34例 ;双抗原夹心 EL ISA检测 SARS临床排除病例特异性抗体阳性 1例 ;SARS病例组特异性抗体阳

Analysis on the Myocardial Enzyme Spectrum and Humoral Immunity of the Clinic Cases Excluded from SARS and SARS

Objective To analyze the character of myocardial enzyme spectrum and humoral immunity of clinic cases excluded from SARS and SARS cases,in order to distinguish SARS from clinic cases excluded from SARS.Methods The serum activity of AST、LDH、CK、CK MB、HBDH and the concentrations of IgG、IgM、IgA,complement 3(C3)、complement 4(C4) and C reactive protein (CRP) of patients in hospitalization for 2 d were detected by rate nephelometry method and by the method IFCC recommended,and the specific antibody were detected by the Indirect ELISA and the Double antigen sandwich method.Results The levels of AST in the serum of clinic cases excluded from SARS group are markedly lower than that of SARS group(P<0.05),the levels of LDH、HBDH in the serum of clinic cases excluded from SARS are also markedly lower than that of SARS group (P<0.01),the differences of the activity of CK、CK MB in the serum between clinic cases excluded from SARS group and SARS group aren′t significant (P>0.05).the concentrations of CRP in the serum of clinic cases excluded from SARS group are markedly lower than that of SARS group(P<0.05);difference of serum concentrations of IgG、IgM、IgA、C3 and C4 between clinic cases excluded from SARS and SARS group aren′t remarkable.the specific IgG、IgM antibody of 18 cases excluded from SARS are all negative;IgG of 32 cases is positive,IgM of 19 cases is positive of 45 cases SARS patients,the total positive cases of IgG and IgM come to 34 by the indirect ELISA.the specific antibody of 1 cases is positive of 18 cases excluded from SARS,and 38 of 45 cases SARS are positive by the double antigen sandwich method,the differences of two group are greatly remarkable(P<0.01).Conclusion:The levels of CRP,the activity of AST、LDH、HBDH and the positive rate of the specific antibody in the serum of clinic cases excluded from SARS are markedly lower than that of SARS group.