HFRS患者特异性IgA、IgE抗体及其免疫复合物测定

1、    HFRS患者特异性IgA、IgE抗体及其免疫复合物测定             作者：佚名时间：2007-11-22 12:16:00                     摘 要 为进一步研究HFRS免疫损伤机制，用ELISA法

2、同步测定了108例不同临床型、不同病日、病期HFRS患者血清中特异性IgA、IgE抗体以及HFRS病毒特异性IgA、IgE型CIC的水平及检出率。发现HFRS-IgA型抗体在轻型病例高于中、重型病例；HFRS-IgE型抗体及IgE型CIC在重型病例高于中、轻型病例。上述差异在病程早期(发热、休克少尿期，或是38病日)尤为突出。IgA型CIC则未见到上述差异。Studies on Detection of Serum Specific IgA, IgE Antibodies and Circulation Immune Complexes in Patients of Hemorrhagic F

3、ever with Renal Syndrome Abstract Detection had been made for the levels of serum specificity IgA, IgE antibodie and specificity of virus antigens circulation immune complexes (CIC) on the different days or phases of illness and clinic types in patients of HFRS. The results showed that the leve

4、l of specific IgA antibody was higher in slight cases than in middle and severe; specific IgE antibody and its CIC was higher in severe cases than in slight and middle. Those differences were apparent in acute phase (illness phase of fever and shock-oilguria, or 3-8 days after illness). But specific

5、 CIC IgA types had no diferences.Key words Hemorrhagic Fever with Renal Syndrome (HFRS), Specific IgA antibody, Specific IgE antibody, Circulating Immune Complexes (CIC), ELISA对肾综合征出血热(HFRS)免疫发病机理研究较多的是IgG、IgM、IgE型抗体14。已有报告在HFRS患者血清中可检测到特异性IgA抗体56。为进一步了解HFRS患者发病过程中特异性抗体及其循环免疫复合物的形成及其致病性，我们平行测定了特异性Ig

6、A、IgE抗体以及抗原特异性IgA、IgE型循环免疫复合物(CIC)的水平，并从临床分型、病期、病日等角度作了对比分析。1 材料与方法1.1 HFRS病人血清 采集本市54例HFRS病人进出院时血清共108份。IgA型检测108份，IgE型检测其中93份。血清病期、病型分布见表1。表1 待测血清病期、病型分布Table 1 Phases and types of illness for collected sera病期phase of illness 轻slight 中middle 重severe 合计total 发热 fever (18) 16 (18) 17 (2) 2 (38) 35 休

7、克少尿 shock & oilguria (1) 0 8 (7) (5) 5 (14) 12 多尿 polyuria (8) 6 (14) 11 (3) 3 (25) 20 恢复 recovery (15) 12 (12 )11 (3) 4 (31) 26 合计 total (42) 34 (52) 46 (14) 13 (108) 93 注： ( )外为IgE型，( )内为IgA型检测血清数。Note: The numbers out of the parenthesis are the types of IgE antibody tested and in the parenthe

8、sis are the numbers of tested IgA.1.2 试剂2 结果2.1 不同病期、临床型HFRS病人血清中特异性抗体及特异性CIC水平(几何平均滴度、GMT)及阳性率结果。见表2。表2 不同病期HFRS病人血清特异性IgA、IgE抗体及其特异性CIC的GMT值与阳性率测定结果Table 2 The results of specific IgA, IgE antibodies and specific circulating immue complex in different illness phases of HFRS抗体型别type ofantibody 病期ph

9、ase ofillness 病例数numbers of case 轻型slight (positive rate)(%) 中型middle (positive rate)(%) 抗体specificantibody CIC antigen specific 抗体specificantibody CIC antigen specific 发热fever 38 104.76(100.00) 11.41(55.56) 34.34(83.33) 3.21(61.11) 休克少尿 14 320.00(1/1) 80.00(1/1) 95.14(100.00) 17.84(87.50) shock &am

10、p; oilguria IgA型 多尿polyuria 25 246.75(100.00) 21.87(62.50) 185.62(100.00) 30.25(85.71) 恢复recovery 31 367.58(100.00) 28.99(80.00) 213.58(100.00) 11.48(58.33) 综算total 108 204.88(100.00) 18.88(66.67) 96.43(94.23) 10.25(63.46) 发热fever 35 29.58(81.25) 11.76(56.25) 57.81(88.24) 15.28(70.59) 休克少尿 12 - - 11

11、4.95(100.00) 12.63(71.43) shock & oilguria IgE型 多尿polyuria 20 100.80(100.00) 7.10(50.00) 249.99(100.00) 15.26(63.64) 恢复recovery 26 269.12(100.00) 5.53(41.67) 386.53(100.00) 7.48(54.55) 综算total 93 80.06(91.18) 8.24(50.00) 148.64(95.65) 12.51(67.39) 抗体型别type ofantibody 病期phase ofillness 病例数numbers

12、 ofcase 重型severe (positive rate)(%) 合计total (positive rate)(%) 抗体specificantibody CICantigen specific 抗体specificantibody CICantigen specific 发热fever 38 56.57(2/2) 0.00(0/2) 59.79(92.11) 5.51(44.74) 休克少尿 14 28.99(80.00) 43.94(80.00) 67.87(92.86) 27.40(85.71) shock & oilguria IgA型 多尿polyuria 25 50

13、7.97(100.00) 40.00(100.00) 229.44(100.00) 28.20(80.00) 恢复recovery 31 320.00(100.00) 26.75(75.00) 292.62(100.00) 20.05(70.93) 综算total 108 116.96(92.86) 21.76(71.43) 132.54(96.30) 14.33(65.74) 发热fever 35 160.00(2/2) 56.57(2/2) 45.11(85.71) 14.61(65/71) 休克少尿 12 160.00(100.00) 69.64(100.00) 151.04(100.0

14、0) 25.72(83.33) shock & oilguria IgE型 多尿polyuria 20 507.97(100.00) 7.37(66.67) 211.72(100.00) 10.88(65.00) 恢复recovery 26 640.00(100.00) 9.28(66.67) 346.64(100.00) 6.67(50.00) 综算total 93 287.63(100.00) 45.37(84.62) 130.01(94.61) 11.85(63.44) 注：( )外数字为GMT值，( )内数字为检出率。Note: The numbers out of the p

15、arenthesis are the values of GMT (Geometric Mean Titer) and the numbers in the parenthesis are the positive rate.2.2 不同病日检出结果。见表3。表3 不同病日HFRS患者血清特异性IgA、IgE抗体及其特异性CIC的GMT值与检出率测定结果Table 3 The results of specific IgA, IgE antibodies and specific circulating immune complex on different days of illness in HFRS patients抗体型别type ofantibody 病日days ofillness 病例数numbers ofcase 轻型slight (positive rate)(%) 中型middle (positive rate)(%) 抗体specificantibody CICantigen specific 抗体specificantibody CICantigen specific 0 10 126.96(100.00) 5.63(33.33) 11.70(2/3) 7.37(1/3) 4 40 104.39(100.00) 18.36(61.54