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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (5): 46-50.doi: 10.6040/j.issn.1671-7554.0.2020.484

• • 上一篇    

化学发光法检测新型冠状病毒抗体在临床的应用价值

李晓非,刘贵明,李婉澜,吕松琴,聂磊,张娟,徐丽萍,陆霓虹   

  1. 昆明市第三人民医院检验科, 云南 昆明 650041
  • 发布日期:2022-09-27
  • 通讯作者: 陆霓虹. E-mail:602157606@qq.com

Application value of chemiluminescent immunoassay in the detection of 2019-nCoV antibodies

LI Xiaofei, LIU Guiming, LI Wanlan, LYU Songqin, NIE Lei, ZHANG Juan, XU Liping, LU Nihong   

  1. Department of Laboratory, Kunming Third Peoples Hospital, Kunming 650041, Yunnan, China
  • Published:2022-09-27

摘要: 目的 探讨化学发光法检测2019新型冠状病毒(2019-nCoV)抗体在临床诊断中的应用价值。 方法 比较化学发光法与胶体金法对18例确诊的新型冠状病毒肺炎患者样本的检测结果,并随机挑选其中2例确诊样本梯度稀释后用以上两种方法检测其灵敏度。然后使用化学发光法检测临床确诊的39例新型冠状病毒肺炎患者的血清样本与90例健康人群的血清样本。再使用化学发光法检测不同感染时期的患者血清样本,统计不同发病时期抗体的检出率。 结果 两种方法检测18例确诊新型冠状病毒肺炎患者的血清样本均为阳性;2例确诊患者样本稀释625倍后用化学发光法仍可检测出抗体阳性,而胶体金法能检测出的样本最大稀释比例为25倍。对确诊患者系列标本的检测中,化学发光法的敏感度为82.05%,特异性为100%,与临床诊断一致性程度较高(Kappa值为0.864),化学发光法对血清样本中抗体的检出率随发病时间推移而升高。 结论 化学发光法抗体检测灵敏度高于胶体金法,自动化程度高,可用于大样本的快速筛查,其检测性能能够满足临床2019-nCoV感染病例的辅助诊断需要。

关键词: 新型冠状病毒, 化学发光法, 胶体金法, 特异性抗体

Abstract: Objective To evaluate the application value of chemiluminescent immunoassay in the detection of 2019-nCoV antibodies. Methods The sample results from 18 confirmed COVID-19 cases detected by chemiluminescent immunoassay and colloidal gold kit were compared, and 2 samples were randomly selected and tested with the above two methods after gradient dilution. The blood samples of 39 clinically diagnosed COVID-19 cases and 90 healthy controls were detected with chemiluminescent immunoassay, and the detection rates of antibodies in different stages of disease were recorded. Results Chemiluminescent immunoassay and colloidal gold method showed all of 18 patients’ samples were positive. After 625 times dilution, the 2 samples were still positive by chemiluminescent immunoassay, but the maximum dilution rate by colloidal gold reagent was 25 times. The sensitivity and specificity of chemiluminescent immunoassay for COVID-19 were 82.05% and 100%, respectively, which were consistent with the clinical diagnosis(kappa value was 0.864). The detection rate of antibodies in serum samples by chemiluminescent immunoassay increased with the time of onset. Conclusion Chemiluminescent immunoassay has higher sensitivity than colloidal gold method in the detection of 2019-nCoV antibodies, which can be used for rapid screening of a large number of samples. Chemiluminescent immunoassay can serve as a supplementary detection method of 2019-nCoV.

Key words: Novel coronavirus, Chemiluminescent immunoassay, Colloidal gold method, Specific antibody

中图分类号: 

  • R446.6
[1] Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019 [J]. N Engl J Med, 2020, 382(8): 727-733.
[2] 里进, 叶光明, 陈良君, 等. 新型冠状病毒(2019-nCoV)核酸检测假阴性结果原因分析及对策[J]. 中华检验医学杂志, 2020, 43(3): 221-225. LI Jin, YE Guangming, CHEN Liangjun, et al. Analysis of false-negative results for 2019 novel coronavirus nucleic acid test and related countermeasures [J]. Chinese Journal of Laboratory Medicine, 2020, 43(3): 221-225.
[3] 童永清, 汪明, 徐万洲, 等. 新型冠状病毒核酸检测临床实验室操作规范的建议[J]. 中华检验医学杂志, 2020, 43(3): 209-212. TONG Yongqing, WANG Ming, XU Wanzhou, et al. Proposal for standardization of 2019-nCoV nucleic acid detection in clinical laboratories [J]. Chinese Journal of Laboratory Medicine, 2020, 43(3): 209-212.
[4] Corman VM, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus(2019-nCoV)by real-time RT-PCR [J]. Euro Surveill, 2020, 25(3): 2000045.
[5] 王成彬. 核酸检测用于确诊新型冠状病毒肺炎阳性率低的原因分析[J]. 中华医学杂志, 2020, 100(13):961-964. WANG Chengbin. Analysis of low positive rate of nucleic acid detection method used for diagnosis of novel coronavirus pneumonia [J]. National Medical Journal of China, 2020, 100(13):961-964.
[6] 中华医学会检验医学分会. 新型冠状病毒肺炎病毒核酸检测专家共识[J]. 中华医学杂志, 2020, 100(13): 968-973.
[7] Branche AR, Walsh EE, Formica MA, et al. Detection of respiratory viruses in sputum from adults by use of automated multiplex PCR [J]. J Clin Microbiol, 2014, 52(10): 3590-3596.
[8] 倪勤, 丁丞, 李永涛, 等. 中低剂量糖皮质激素影响新型冠状病毒清除时间的回顾性研究[J]. 中华临床感染病杂志, 2020, 13(1): 21-24. NI Qin, DING Cheng, LI Yongtao, et al. Effect of low-to-moderate dose glucocorticoids on viral clearance in COVID-19: a retrospective study [J]. Chinese Journal of Clinical Infectious Diseases, 2020, 13(1): 21-24.
[9] Dörner T, Radbruch A. Antibodies and B cell memory in viral immunity [J]. Immunity, 2007, 27(3): 384-392.
[10] 杨旭丽, 王志慧, 刘星, 等. 新型冠状病毒肺炎疑似病例274例的筛检方案[J]. 中华传染病杂志, 2020, 38(2020-03-09). doi:10.3760/cma.j.cn311365-20200218-00081. YANG Xuli, WANG Zhihui, LIU Xing, et al. Screening for 274 suspected cases of novel coronavirus pneumonia [J]. Chinese Journal of Infectious Diseases, 2020, 38(2020-03-09). doi:10.3760/cma.j.cn311365-20200218-00081.
[11] 张瑞, 李金明. 如何减少新型冠状病毒核酸检测的“假阴性”[J]. 中华医学杂志, 2020,100(11): 801-804. ZHANG Rui, LI Jinming. The way to reduce the “false negative results” of 2019 novel coronavirus nucleic acid detection [J]. National Medical Journal of China, 2020, 100(11): 801-804.
[12] 徐万洲, 李娟, 何晓云, 等. IgM和IgG抗体联合检测在新冠病毒感染中的诊断价值[J]. 中华检验医学杂志, 2020, 43(3): 230-233. XU Wanzhou, LI Juan, HE Xiaoyun, et al. The diagnostic value of joint detection of serum IgMand IgG antibodies to 2019-nCoV in 2019-nCoV infection [J]. Chinese Journal of Laboratory Medicine, 2020, 43(3): 230-233.
[13] 国家卫生健康委员会.新型冠状病毒肺炎诊疗指南(试行第7版)[J]. 天津中医药大学学报, 2020,39(2):121-127.
[14] 罗效梅, 王静, 张娅, 等. 全血 SARS-CoV-2 特异性抗体检测对 2019-冠状病毒病的临床应用价值分析[J].西南大学学报(自然科学版),2020,42(3):30-34. LUO Xiaomei, WANG Jing, ZHANG Ya, et al. Detection of Specific SARS-CoV-2IgM and IgG Antibodiesin COVID-19 and Its Clinical Application[J]. Journal of Southwest University(Natural Science Edition), 2020,42(3):30-34.
[15] World Health Organization. Coronavirus disease(COVID-19)technical guidance: Laboratory testing for 2019-nCoV in humans [EB/OL].(2020-02-04)[2020-02-14]. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance.
[16] Centers for disease control and prevention, respiratory viruses branch, division of viral diseases. Real-time RT-PCR panel for detection 2019-novel coronavirus [EB/OL].(2020-02-04)[2020-02-14].https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-for-detection-instructions.pdf.
[17] 唐鹏, 赵自武, 刘颖娟, 等. 化学发光和胶体金法检测新型冠状病毒特异性抗体比较及其临床意义[J]. 武汉大学学报(医学版), 2020,41(2020-03-29). doi:10.14188/j.1671-8852.2020.0131. TANG Peng, ZHAO Ziwu, LIU Yinjuan, et al. Comparison between chemiluminescence and colloidal gold method in the detection of 2019 novel coronavirus specific antibodies and the value in the COVID-19 diagnosis and treatment [J]. Medical Journal of Wuhan University, 2020,41(2020-03-29). doi:10.14188/j.1671-8852.2020.0131.
[18] 薛雄燕, 朱嫦琳, 黄少珍, 等.血液样本灭活处理对三种SARS-CoV-2抗体检测方法结果的影响[J]. 南方医科大学学报, 2020, 40(3): 316-320. XUE Xiongyan, ZHU Changlin, HUANG Shaozhen, et al. Effect of heat inactivation of blood samples on the efficacy of three detection methods of SARS-CoV-2 antibodies [J]. Journal of Southern Medical University, 2020, 40(3): 316-320.
[19] Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin [J]. Nature, 2020, 579(7798):270-273.
[20] 李晖, 李咏茵, 张志高, 等. 2019新型冠状病毒抗体胶体金检测方法的建立与临床性能评价[J]. 中华传染病杂志, 2020, 38(2020-03-03). http://rs.yiigle.com/yufabiao/1183332. htm. doi:10.3760/cma.j.cn311365-20200221-00101. LI Hui, LI Yongyin, ZHANG Zhigao,et al. Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method [J]. Chinese Journal of Infectious Diseases, 2020, 38(2020-03-03). doi:10.3760/cma.j.cn311365-20200221-00101.
[21] 邹明园,吴国球.抗原交叉反应对新型冠状病毒血清特异性抗体检测的影响[J]. 临床检验杂志, 2020,38(3):161-163.
[22] 吕志文, 申爱华, 陈小三, 等. 化学发光法与免疫印迹法检测抗SSA和SSB抗体的临床对比研究[J]. 国际检验医学杂志, 2018, 39(15): 1845-1852. LV Zhiwen, SHEN Aihua, CHEN Xiaosan, et al. The comparison between chemiluminescent immunoassay and line immunoassay for the detection to anti-SAA and SSB autoantibodies [J]. International Journal of Laboratory Medicine, 2018, 39(15): 1845-1852.
[23] Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019 [J]. Clin Infect Dis,2020.Mar 8. pii: ciaa344. doi: 10.1093/cid/ciaa344.
[24] 李萍, 李志勇, 赵四林, 等. 血清2019-nCoV IgM和IgG抗体用于诊断新型冠状病毒肺炎的初步探讨[J]. 中华检验医学杂志, 2020, 43(2020-03-08). doi:10.3760/cma.j.cn114452-20200302-00155. LI Ping, LI Zhiyong, ZHAO Silin, et al. Preliminary study of serum 2019-nCoV IgM and IgG antibodies in the diagnosis of Novel Coronavirus Pneumonia [J]. Chinese Journal of Laboratory Medicine, 2020, 43: Epub ahead of print. Doi: 10.3760/cma.j.cn114452-20200302-00155.
[25] 黄悦, 庄春兰, 葛胜祥, 等. 2019新型冠状病毒感染血清学检测的临床和公共卫生意义探讨[J]. 病毒学报, 2020,41(2020-03-27). doi: 10.13242/j.cnki.bingduxuebao.003678. HUANG Yue, ZHUANG Chunlan, GE Shengxiang, et al. The Values of Serological Test in Clinical and Public Health Practices of SARS-CoV-2 Infection [J]. Chinese Journal of Virology, 2020,41(2020-03-27). doi: 10.13242/j.cnki.bingduxuebao.003678.
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