COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体 变化和核酸清除研究

doi:10.19871/j.cnki.xfcrbzz.2023.01.002

新发传染病电子杂志 ›› 2023, Vol. 8 ›› Issue (1): 8-13.doi: 10.19871/j.cnki.xfcrbzz.2023.01.002

COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体变化和核酸清除研究

林国跃¹, 段丽², 秦莹¹, 李远达², 孙贤黎³, 张剑锋⁴, 张弛², 赵豆豆², 屈晓娟², 杨振萍², 撒玉玲², 曹莉莉², 关文龙⁴, 王泉², 蔺志强², 许珺⁵

1.新疆医科大学第八附属医院输血科,新疆乌鲁木齐 830013;
2.新疆医科大学第八附属医院检验科,新疆乌鲁木齐 830013;
3.新疆医科大学第八附属医院ICU科,新疆乌鲁木齐 830013;
4.新疆医科大学第八附属医院呼吸科,新疆乌鲁木齐 830013;
5.新疆医科大学第八附属医院感染内科,新疆乌鲁木齐 830013

收稿日期:2021-12-19 出版日期:2023-02-28 发布日期:2023-03-30
通讯作者: 许珺,Email：598957043@qq.com
基金资助:
新疆医科大学第八附属医院（原新疆维吾尔自治区第六人民医院）院级课题（QLY-KY-2020001）

Study on the changes of antibodies and nucleic acid clearance in patients with COVID-19 during the recovery period in the treatment of COVID-19

Lin Guoyue¹, Duan Li², Qin Ying¹, Li Yuanda², Sun Xianli³, Zhang Jianfeng⁴, Zhang Chi², Zhao Doudou², Qu Xiaojuan², Yang Zhenping², Sa Yuling², Cao Lili², Guan Wenlong⁴, Wang Quan², Lin Zhiqiang², Xu Jun⁵

1. Department of Blood Transfusion, The Eighth Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830013, China;
2. Department of Clinical Laboratory, The Eighth Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830013, China;
3. Department of ICU, The Eighth Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830013, China;
4. Department of Respiratory, The Eighth Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830013, China;
5. Department of Infectious Medicine, The Eighth Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830013, China

Received:2021-12-19 Online:2023-02-28 Published:2023-03-30

摘要/Abstract

摘要： 目的探讨使用COVID-19康复者恢复期血浆治疗COVID-19患者后体内抗体IgM、IgG的产生和病毒核酸转阴变化规律以及临床治疗效果,为特异性抗体治疗COVID-19提供依据。方法应用COVID-19康复者恢复期血浆治疗75例COVID-19住院患者为输血组,未进行输血治疗200例为未输血组,定时检测两组患者体内抗体IgM和IgG及核酸基因ORF1ab和N含量,并统计比对分析。结果 ①输血组患者输注血浆后体内抗体IgM和IgG含量（47.89±64.63、68.70±69.14）分别高于输血前抗体IgM和IgG含量（4.55±11.02、4.46±13.99）差异均有统计学意义（P<0.05）;输血组出院时患者抗体IgM和IgG含量（47.89±64.63、68.70±69.14）较未输血组（17.33±16.26、43.41±35.61）均明显的提高（P<0.05）;输血后中型、重型和危重型患者抗体IgM和IgG含量（45.63±54.19,63.69±85.75,28.80±35.54;55.15±59.09,99.6±79.49,57.21±52.50）均高于输血前（3.78±9.85,3.88±10.07,7.49±14.22;2.98±12.23,6.05±18.24,5.88±10.07）（P<0.05）;并且中型抗体IgM（45.63±54.19）和重型IgM（63.69±85.75）含量均明显高于危重型患者抗体IgM（28.80±35.54）含量（P<0.05）。②输血组新型冠状病毒核酸基因ORF1ab和N清除率（61.33%）高于同期未输血组（26.50%）（P<0.005）。③输血组中型和重型患者住院天数[（24.00±8.68）d,（28.00±11.46）d]较未输血组[（31.00±6.33）d,（39.00±8.69）d]均明显缩短（P<0.05）。结论应用COVID-19康复者恢复期血浆治疗COVID-19患者,可明显提高重型和危重型患者体内抗体IgM和IgG含量、增强免疫功能、加快病毒清除及核酸转阴率。

关键词: 新型冠状病毒, 康复者恢复期血浆, 治疗, 抗体, 核酸

Abstract: Objective To explore the production of antibodies IgM and IgG in the body of patients with COVID-19 after treatment with convalescent plasma of convalescent patients with novel coronavirus, and the regularity of viral nucleic acid negative change and clinical treatment effect, so as to provide basis for specific antibody treatment of COVID-19. Method 75 cases of COVID-19 hospitalized patients were treated with plasma from convalescent patients of COVID-19 as the blood transfusion group, and 200 cases were not treated with blood transfusion as the non blood transfusion group. The contents of antibody IgM and IgG, nucleic acid gene ORF1ab and N in the two groups were detected regularly, and analyzed statistically. Result ① The levels of antibody IgM and IgG (47.89±64.63, 68.70±69.14) in the blood transfusion group after plasma transfusion were significantly higher than those before blood transfusion (4.55±11.02, 4.46±13.99, respectively) (P<0.05); The levels of IgM and IgG in the blood transfusion group at discharge (47.89±64.63, 68.70±69.14) were significantly higher than those in the non blood transfusion group (17.33±16.26, 43.41±35.61) (P<0.05); The levels of IgM and IgG (45.63±54.19, 63.69±85.75, 28.80±35.54; 55.15± 59.09, 99.6±79.49, 57.21±52.50) in patients with rapidly developing type, severe type and critical type after blood transfusion were higher than those before blood transfusion (3.78±9.85, 3.88± 10.07, 7.49±14.22; 2.98±12.23, 6.05±18.24, 5.88±10.07) (P<0.05), In addition, the contents of rapidly developing IgM (45.63±54.19) and severe IgM (63.69±85.75) were significantly higher than those of critically ill patients (28.80±35.54) (P<0.05). ② The clearance rate of ORF1ab and N gene in COVID-19 patients in blood transfusion group (61.33%) was significantly higher than that in non blood transfusion group (26.50%) in the same period (P<0.005). ③ The hospitalization days [(24.00±8.68)d,(28.00±11.46)d] of rapidly developing and severe patients in the blood transfusion group were significantly shorter than those in the non blood transfusion group [(31.00±6.33)d, (39.00±8.69)d] (P<0.05). Conclusion The application of COVID-19 convalescent frozen plasma in the treatment of COVID-19 patients can significantly increase the content of antibody IgM and IgG, enhance immune function, speed up virus clearance and nucleic acid negative rate in severe and critical patients.

Key words: Novel coronavirus, Plasma of convalescent patients, Treatment, Antibodies, Nucleic acid

中图分类号:

林国跃, 段丽, 秦莹, 李远达, 孙贤黎, 张剑锋, 张弛, 赵豆豆, 屈晓娟, 杨振萍, 撒玉玲, 曹莉莉, 关文龙, 王泉, 蔺志强, 许珺. COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体变化和核酸清除研究[J]. 新发传染病电子杂志, 2023, 8(1): 8-13.

Lin Guoyue, Duan Li, Qin Ying, Li Yuanda, Sun Xianli, Zhang Jianfeng, Zhang Chi, Zhao Doudou, Qu Xiaojuan, Yang Zhenping, Sa Yuling, Cao Lili, Guan Wenlong, Wang Quan, Lin Zhiqiang, Xu Jun. Study on the changes of antibodies and nucleic acid clearance in patients with COVID-19 during the recovery period in the treatment of COVID-19[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(1): 8-13.

参考文献

[1] 王馨语,廖静,陈俊.新型冠状病毒肺炎免疫学特征及免疫治疗策略的研究进展[J].热带医学杂志,2020,20(5):571-575,602.
[2] 中华人民共和国国家卫生健康委员会.新型冠状病毒肺炎诊疗方案 (试行第七版)[EB/OL]. (2020-03-04).http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.html.
[3] 中华人民共和国国家卫生健康委办公厅.2020年2月17日新闻发布会文字实录[EB/OL].[2020-02-26].http://www.nhc.gov.cn/xcs/yqfkdt/202002/f12a62d10c2a48c6895cedf2faea6e1f.shtml.
[4] MARKUS H, HANNAH K, NADINE K, et al. The novel coronavirus2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells [EB/OL].(2020-01-31).[2020-02-23].https://www.biorxiv.org/ content/10.1101/2020.01.31.929042v1.
[5] 杨晓明,侯继峰. 康复期血浆应用于急性病毒性传染病现状及其治疗新型冠状病毒肺炎前景[J]. 中国生物制品学杂志,2020,33(3):241-245.
[6] CHENG Y, WONG R, SOO YO, et al.Use of convalescent plasma therapy in SARS patients in Hong Kong[J].Eur J Clin Microbiol Infect Dis,2005,24(1):44-46.
[7] MUPAPA K, MASSAMBA M, KIBADI K, et al. Treatment of Ebola hemorrhagic fever with blood transfusions from convalescent patients[J].J Infect Dis, 1999, 179 Suppl 1:S18-23.
[8] ZHOU BP, GUAN Y, ZHONG NS.Treatment with convalescent plasma for influenza A(H5N1)infeetion[J]. N Eng J Med, 2007, 357(14):1450-1451.
[9] FLETCHER TE, FISCHER WAND, JACOB ST.Convalescent plasma for Ebola virus disease[J]. N Engl J Med, 2016, 374(25): 2499–2500.
[10] 陆贤吉, 马幼丽. 临床输血不良反应调查分析[J].临床血液学杂志(输血与检验), 2015, 28(4):724-725.
[11] JONGERIUS I, PORCELI JNL, VAN BEEK AE, et al.The role of complement in transfusion-related acute lung injury[J].Transfus Med Rev, 2019,33(4): 236-242.
[12] 原庆, 孙凤霞, 姜慧敏, 等. 恢复期血浆治疗在呼吸道冠状病毒感染疫情中的应用进展[J].中国合理用药探索, 2020, 17(5):1-5.
[13] QIU X, HONG C, LI Y, et al.Calreticulin as a hydrophilic chi- meric molecular adjuvant enhances IgG responses to the spike protein of severe acute respiratory syndrome coronavirus[J].Microbiol Immunol,2012,56( 8) : 554-561.
[14] LIU L, WEI Q, LIN Q, et al.Anti-spike IgG causes severe a- cute lung injury by skewing macrophage responses during acute SARS-CoV infection[J].JCI Insight, 2019, 4(4):123-158.
[15] FOOB B.Influenza pneumonia treated by blood transfusions[J].NY Med, 1919, 109:765.
[16] 中华人民共和国国家卫生健康委办公厅,中共中央军委后勤保障部卫生局. 关于印发新冠肺炎康复者恢复期血浆临床治疗方案 (试行第二版) 的通知[EB/OL]. (2020-03-04). http:// www.gov.cn/ zhengce /zhengceku/ 2020-03/05/ content_5487145.html.
[17] ZHOU BP, ZHONG NS, YI G.Treatment with convalescent plasma for influenza A (H5N1) Infection[J].N Engl J Med, 2007, 357(14):1450-1451.
[18] 牛培华, 谭文杰. 中东呼吸综合征抗病毒治疗研究进展[J].病毒学报, 2018, 34(5):599-605.
[19] 李剑平, 李晓丰, 赵立哲, 等. 输血相关治疗应用于新冠病毒肺炎救治中的思考[J]. 临床输血与检验, 2020, 28(3):228-231.
[20] LI G, FAN Y, LAI Y, et al.Coronavirus infections and immune responses[J]. J Med Virol, 2020, 92(4):424-432.
[21] LIU Y, CAO W, SUN M, et al.Broadly neutralizing antibodies for HIV-1: efficacies, challenges and opportunities[J].Emerg Microbes Infect,2020,9(1):194-206.
[22] MELLOR JD, BROWN MP, IRVING HR, et al.A critical review of the role of Fc gamma receptor polymorphisms in the response to monoclonal antibodies in cancer[J]. J Hematol, 2013, 6:1.
[23] ZHU J, KIM J, XIAO X, et al. Profiling the immune vulnerability landscape of the2019 Novel Coronavirus[J]. bioRxiv, 2020: 2020.02.08.939553.
[24] PHAN T.Novel coronavirus: from discovery to clinical diagnostics[J]. Infect Genet E vol, 2020, 79: 104211.
[25] 宁雅婷, 侯欣, 陆旻雅, 等. 新型冠状病毒血清特异性抗体检测技术应用探讨[J].协和医学杂志, 11(6):649-653.
[26] 何超, 江虹, 谢轶, 等.新型冠状病毒肺炎诊治的实验室检验路径探讨[J].中国呼吸与危重监护杂志, 2020, 19(2):125-127.
[27] CUI J, LI F, SHI ZL.Origin and evolution of pathogenic corona viruses[J]. Nat Rev Microbiol, 2018, 17(3):181-192.
[28] FRICKER-HIDALGO H, BAILLY S, MARIE-PIERRE B, et al.How toestimate time of infection with Toxoplasma gondii in pregnant women. Use of specific IgG and IgM kinetics by 7 techniques on 691 sera[J].Diagnostic Microbiology and Infectious Disease, 2020, 96(4):114987.

COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体变化和核酸清除研究

Study on the changes of antibodies and nucleic acid clearance in patients with COVID-19 during the recovery period in the treatment of COVID-19

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	冯司旸, 逯建华, 廖玉学, 张振, 郭寅生, 吕秋莹, 孔东锋, 陈志高, 邹旋, 冯铁建, 廖异. 浅论我国新型冠状病毒感染防控策略调整的现实必要性[J]. 新发传染病电子杂志, 2023, 8(1): 1-7.
[2]	宋敏, 陆普选, 方伟军, 韩远远, 梁瑞云. 2022年WHO全球结核病报告：全球与中国关键数据分析[J]. 新发传染病电子杂志, 2023, 8(1): 87-92.
[3]	深圳市第三人民医院, 国家感染性疾病临床医学研究中心, 深圳市感染性疾病质量控制中心. 深圳市成人新型冠状病毒奥密克戎变异株感染重症临床救治专家共识[J]. 新发传染病电子杂志, 2023, 8(1): 93-101.
[4]	沈银忠, 李太生. 从我国艾滋病诊疗指南的变迁看艾滋病防治工作的进展与成效[J]. 新发传染病电子杂志, 2022, 7(4): 1-5.
[5]	刘凤云, 李伟新, 欧健, 文乐敏. 艾滋病抗反转录病毒治疗后月经不调的中医药治疗研究进展[J]. 新发传染病电子杂志, 2022, 7(4): 91-94.
[6]	王长泰, 刘林娜, 赵令斋, 张复春. 《猴痘诊疗指南（2022年版）》解读[J]. 新发传染病电子杂志, 2022, 7(3): 12-17.
[7]	张影, 李晓鹤, 陈凤, 袁静. 新型冠状病毒德尔塔和奥密克戎变异株感染患者的临床特征分析[J]. 新发传染病电子杂志, 2022, 7(3): 22-26.
[8]	李力, 张鑫, 戴慕巍, 郑欢伟, 康海燕, 许怡, 胡倩, 杨莉, 高会霞, 王瑜玲, 江平, 戴二黑. 氨溴索治疗新型冠状病毒肺炎的临床效果分析[J]. 新发传染病电子杂志, 2022, 7(3): 27-31.
[9]	付寒, 王鹏, 张宗华, 季乐财. 标准抗结核治疗方案对耐多药肺结核患者肾功能的影响分析[J]. 新发传染病电子杂志, 2022, 7(3): 32-36.
[10]	周明, 黄丽花, 龚世江, 黄葵. 抗病毒治疗失败的HIV感染/AIDS患者基因型耐药特征分析[J]. 新发传染病电子杂志, 2022, 7(3): 37-40.
[11]	刘星, 吴威, 张晓明, 李强, 权冬梅, 张朕, 戴越, 张麟格, 宋冠男, 李欣悦, 朱一丹, 王岩. 非酒精性脂肪性肝病及原发性肝细胞癌患者接种新型冠状病毒灭活疫苗的安全性及免疫原性[J]. 新发传染病电子杂志, 2022, 7(3): 50-54.
[12]	袁静, 谭晓华, 王福祥, 王绿化, 卢洪洲. 恶性肿瘤患者新冠病毒疫苗接种的专家意见[J]. 新发传染病电子杂志, 2022, 7(2): 1-5.
[13]	刘文浩, 杨金荣, 陈一鑫, 周昀, 李银凤, 云永兴, 杨根东, 黄华. 新型冠状病毒奥密克戎变异株感染：普通型与无症状/轻型的临床特征比较分析及胸部CT表现[J]. 新发传染病电子杂志, 2022, 7(2): 6-10.
[14]	刘栋, 王帅迪, 冯明男, 黄顺星, 李硕, 杜霄鹏, 刘亚欧, 丁金立. 新型冠状病毒肺炎防控常态化情况下隔离区方舱CT的临床应用探讨[J]. 新发传染病电子杂志, 2022, 7(2): 11-14.
[15]	蒋学美, 宋艳, 陈艳, 何利, 邵蔚. 新型冠状病毒肺炎疫情常态化下消毒供应中心的防控策略[J]. 新发传染病电子杂志, 2022, 7(2): 15-18.

COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体 变化和核酸清除研究

Study on the changes of antibodies and nucleic acid clearance in patients with COVID-19 during the recovery period in the treatment of COVID-19

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

COVID-19康复者恢复期血浆治疗COVID-19患者体内抗体变化和核酸清除研究