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摘要为进一步研究hfrs免疫损伤机制，用elisa法同步测定了108例差异临床型、差异病日、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i的程度及检出率。创造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i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i那么未见到上述差异。studiesndetetinfseruspeifiiga,igeantibdiesandirulatiniuneplexesinpatient

2、sfherrhagifeverithrenalsyndrezhangdnghaisunhuigafeng(zibsendhealthshl)abstratdetetinhadbeenadefrthelevelsfseruspeifiityiga,igeantibdieandspeifiityfvirusantigensirulatiniuneplexes(i)nthedifferentdaysrphasesfillnessandlinitypesinpatientsfhfrs.theresultsshedthatthelevelfspeifiigaantibdyashigherinslight

3、asesthaniniddleandsevere;speifiigeantibdyanditsiashigherinsevereasesthaninslightandiddle.thsedifferenesereapparentinautephase(illnessphaseffeverandshk-ilguria,r3-8daysafterillness).butspeifiiigatypeshadndiferenes.keyrdsherrhagifeverithrenalsyndre(hfrs),speifiigaantibdy,speifiigeantibdy,irulatingiune

4、plexes(i),elisa对肾综合征出血热(hfrs)免疫发病机理研究较多的是igg、ig、ige型抗体14。已有陈诉在hfrs患者血清中可检测到特异性iga抗体56。为进一步相识hfrs患者发病历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iga、ige抗体以及抗原特异性iga、ige型循环免疫复合物(i)的程度，并从临床分型、病期、病日等角度作了比拟阐发。1质料与要领1.1hfrs病人血清网罗本市54例hfrs病人收支院时血清共108份。iga型检测108份，ige型检测此中93份。血清病期、病型漫衍见表1。表1待测血清病期、病型漫衍table1phasesa

5、ndtypesfillnessfrlletedsera病期phasefillness轻slight中iddle重severe合计ttal发热fever(18)16(18)17(2)2(38)35休克少尿shkilguria(1)08(7)(5)5(14)12多尿plyuria(8)6(14)11(3)3(25)20规复revery(15)12(12)11(3)4(31)26合计ttal(42)34(52)46(14)13(108)93注：()外为ige型，()内为iga型检测血清数。nte:thenubersutftheparenthesisarethetypesfigeantibdytest

6、edandintheparenthesisarethenubersftestediga.1.2试剂1.3实行要领2效果2.1差异病期、临床型hfrs病人血清中特异性抗体及特异性i程度(多少均匀滴度、gt)及阳性率效果。见表2。表2差异病期hfrs病人血清特异性iga、ige抗体及其特异性i的gt值与阳性率测定效果table2theresultsfspeifiiga,igeantibdiesandspeifiirulatingiueplexindifferentillnessphasesfhfrs抗体型别typefantibdy病期phasefillness病例数nubersfase轻型slig

7、ht(psitiverate)(%)中型iddle(psitiverate)(%)抗体speifiantibdyiantigenspeifi抗体speifiantibdyiantigenspeifi发热fever38104.76(100.00)11.41(55.56)34.34(83.33)3.21(61.11)休克少尿14320.00(1/1)80.00(1/1)95.14(100.00)17.84(87.50)shkilguriaiga型多尿plyuria25246.75(100.00)21.87(62.50)185.62(100.00)30.25(85.71)规复revery31367.

8、58(100.00)28.99(80.00)213.58(100.00)11.48(58.33)综算ttal108204.88(100.00)18.88(66.67)96.43(94.23)10.25(63.46)发热fever3529.58(81.25)11.76(56.25)57.81(88.24)15.28(70.59)休克少尿12-114.95(100.00)12.63(71.43)shkilguriaige型多尿plyuria20220.80(100.00)7.10(50.00)249.99(100.00)15.26(63.64)规复revery26269.12(100.00)5.5

9、3(41.67)386.53(100.00)7.48(54.55)综算ttal9380.06(91.18)8.24(50.00)148.64(95.65)12.51(67.39)抗体型别typefantibdy病期phasefillness病例数nubersfase重型severe(psitiverate)(%)合计ttal(psitiverate)(%)抗体speifiantibdyiantigenspeifi抗体speifiantibdyiantigenspeifi发热fever3856.57(2/2)0.00(0/2)59.79(92.11)5.51(44.74)休克少尿1428.99(

10、80.00)43.94(80.00)67.87(92.86)27.40(85.71)shkilguriaiga型多尿plyuria25507.97(100.00)40.00(100.00)229.44(100.00)28.20(80.00)规复revery31320.00(100.00)26.75(75.00)292.62(100.00)20.05(70.93)综算ttal108116.96(92.86)21.76(71.43)132.54(96.30)14.33(65.74)发热fever35160.00(2/2)56.57(2/2)45.11(85.71)14.61(65/71)休克少尿1

11、2160.00(100.00)69.64(100.00)151.04(100.00)25.72(83.33)shkilguriaige型多尿plyuria20507.97(100.00)7.37(66.67)211.72(100.00)10.88(65.00)规复revery26640.00(100.00)9.28(66.67)346.64(100.00)6.67(50.00)综算ttal93287.63(100.00)45.37(84.62)130.01(94.61)11.85(63.44)注：()外数字为gt值，()内数字为检出率。nte:thenubersutftheparenthesi

12、sarethevaluesfgt(geetrieantiter)andthenubersintheparenthesisarethepsitiverate.2.2差异病日检出效果。见表3。表3差异病日hfrs患者血清特异性iga、ige抗体及其特异性i的gt值与检出率测定效果table3theresultsfspeifiiga,igeantibdiesandspeifiirulatingiuneplexndifferentdaysfillnessinhfrspatients抗体型别typefantibdy病日daysfillness病例数nubersfase轻型slight(psitivera

13、te)(%)中型iddle(psitiverate)(%)抗体speifiantibdyiantigenspeifi抗体speifiantibdyiantigenspeifi010126.96(100.00)5.63(33.33)11.70(2/3)7.37(1/3)440104.39(100.00)18.36(61.54)50.98(95.24)4.60(47.62)iga821319.89(100.00)26.75(75.00)174.44(100.00)11.93(62.50)型1219289.75(100.00)22.87(71.43)170.36(100.00)23.20(81.82

14、)1611320.00(2/2)160.00(2/2)201.57(100.00)24.28(83.33)20287905.10(2/2)28.28(2/2)403.17(100.00)6.84(33.33)综算ttal108204.08(100.00)18.88(66.67)96.47(94.23)10.05(63.46)01027.25(83.33)14.74(66.67)23.39(2/3)40.00(2/3)43636.06(81.82)15.26(63.64)84.14(94.74)15.15(73.68)ige815148.14(100.00)7.01(44.44)228.03(1

15、00.00)7.61(40.00)型1218226.40(100.00)2.08(16.67)319.92(100.00)18.82(72.73)168320.00(1/1)40.00(1/1)320.00(100.00)6.93(60.00)20286640.00(1/1)0.00(0/1)285.08(100.00)2.71(33.33)综算ttal9380.06(91.18)8.24(50.00)148.64(95.65)12.51(67.39)抗体型别typefantibdy病期daysfillness病例数nubersfase重型severe(psitiverate)(%)合计tta

16、l(psitiverate)(%)抗体speifiantibdyiantigenspeifi抗体speifiantibdyiantigenspeifi01080.00(1/1)0.00(0/1)59.29(90.00)3.81(40.00)44030.60(83.33)23.39(66.67)59.61(92.50)9.20(57.50)iga8211280.00(1/1)160.00(1/1)271.24(10.00)21.42(71.43)型121940.00(1/1)40.00(1/1)191.97(100.00)23.75(78.95)1611403.20(3/3)18.57(2/3)

17、268.47(100.00)31.79(81.82)20287640.00(2/2)28.28(2/2)579.66(100.00)15.39(71.43)综算ttal108116.96(92.86)21.76(71.43)132.85(96.30)14.33(65.74)01040.00(1/1)20.00(1/1)27.05(80.00)20.50(80.00)436201.58(100.00)80.00(100.00)75.13(91.67)20.04(75.00)ige815160.00(1/1)0.00(0/1)171.93(100.00)6.33(40.00)型1218640.00

18、(1/1)20.00(1/1)296.29(100.00)9.06(55.56)168639.68(2/2)4.47(1/2)380.54(100.00)7.73(62.50)20286905.10(2/2)28.28(2/2)479.45(100.00)5.02(50.00)综算ttal93287.63(100.00)45.37(84.62)130.01(94.62)11.85(63.44)注：同表2。nte:astable2.3讨论3.1特异性抗体测定据检测效果可见，无论是轻、中或重型病例，hfrs-iga，ige抗体检出程度(gt值)均随病期(病日)希望而渐渐升高，这切合一样平常抗体产生

19、纪律。但从两型特异性抗体检出率角度阐发，那么上述差异不显着。hfrs-iga抗体gt值在轻型病例高于中、重型病例(p0.05)，这一差异在发热期到休克少尿期(或是8病日从前)表示得尤为突出，至规复期(或16病日后)那么表示不显着。hfrs-ige抗体gt值在重型病例始终高于中、轻型，其差异在发热期或病程第一周尤为显着(p0.05)，支持该抗体在病程早期到场病理损伤的不雅点4，8。3.2抗原特异性i测定iga型特异性i的检出率及gt值在病型间均无显着差异(p0.05)。从病期希望或病日角度看，全部病例的检出率及gt值均以休克少尿及多尿期为高，以发热期为低；但在休克少尿、多尿及规复期间均无显着统计学差异(p0.05)。ige型特异性i的检出率及gt值那么在轻、中型与重型病例间存在显着的差异(p0.05)，均以重型病例为高。假设从病期希望角度看，那么轻、中型病例在各病期间无显着差异，但重型病例在发热与休