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目的远期随访严重急性呼吸综合征(SARS)患儿血清中特异性抗SARS相关冠状病毒(CoV)IgG(SARS-CoV-IgG)抗体,并探讨其临床意义。方法儿童SARS临床诊断病例16例和患儿的父母及与其密切接触家庭成员(其中包括7例SARS临床诊断病例、12例非SARS病例)19例。在SARS患儿病程1.5年左右,进行随访。采集患儿及其密切接触家庭成员外周静脉血2 mL,常规分离血清。应用间接免疫荧光法(IFA)检测受试者血清中抗SARS-CoV-IgG抗体。结果16例儿童SARS病例中,8例血清中抗SARS-CoV-IgG阳性,其中4例SARS患病期间抗SARS-CoV-IgM阳性,4例未查抗SARS-CoV-IgM抗体。另8例血清中抗SARS-CoV-IgG阴性,其中4例SARS患病期间抗SARS-CoV-IgM阴性,4例未查抗SARS-CoV-IgM抗体。8例血清中抗SARS-CoV-IgG阳性的SARS患儿的8个家庭中均有2例及2例以上SARS患者。8例血清中抗SARS-CoV-IgG阴性的儿童SARS病例的8个家庭中均只有患儿本人为SARS患者。结论在病程1.5年后,实验室确诊的儿童SARS病例的血清中仍能检测到抗SARS-CoV-IgG抗体。家庭聚集发病是实验室确诊的SARS病例的一个重要特征。
Objective To investigate the serum anti-SARS-CoV IgG (SARS-CoV-IgG) antibodies in children with severe acute respiratory syndrome (SARS) in long-term follow-up and to investigate its clinical significance. Methods Twenty-six cases of clinical diagnosis of SARS in children and 19 cases of parents and their close contacts with family members (including seven clinically diagnosed cases of SARS and 12 cases of non-SARS cases) were included in this study. The course of the disease in children with SARS 1.5 years or so, were followed up. Children and their peripheral blood collected in close contact with family members 2 mL, routine separation of serum. Anti-SARS-CoV-IgG antibodies were detected in sera of subjects using indirect immunofluorescence (IFA). Results Of 16 cases of children with SARS, 8 cases were positive for anti-SARS-CoV-IgG in serum, 4 cases were positive for anti-SARS-CoV-IgM and 4 cases were not anti-SARS-CoV-IgM. Anti-SARS-CoV-IgG was negative in the other 8 cases. Anti-SARS-CoV-IgM was negative in 4 SARS cases and 4 cases were not detected anti-SARS-CoV-IgM antibody. In 8 out of 8 families with SARS-CoV-IgG positive SARS-CoV-IgG in serum of 8 cases, there were 2 cases and 2 cases of SARS patients. Of the eight families of eight SARS-CoV-IgG-negative children with SARS in their serum, only children were themselves SARS patients. Conclusions Anti-SARS-CoV-IgG antibodies can still be detected in the serum of laboratory-confirmed childhood SARS cases after 1.5 years of course of disease. The incidence of familial aggregation is an important feature of laboratory-confirmed SARS cases.