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| 尿素解离试验在减少
新型冠状病毒抗体假阳性中的应用价值 |
| Application value of urea dissociation test in reducing false positive of SARS-CoV-2 antibodies |
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| DOI：10.3969/j.issn.1007-8134.2022.04.003 |
| 中文关键词: 胶体金免疫层析法 新型冠状病毒 新型冠状病毒肺炎 IgM 抗体 IgG 抗体 尿素 假阳性 自身免疫性疾病 |
| 英文关键词: colloidal gold immunochromatography SARS-CoV-2 COVID-19 IgM antibody IgG antibody urea false positive autoimmune disease |
| 基金项目:重庆市2020年科卫联合医学科研项目（2020FYYX161、2020FYYX098、2020FYYX118）；重庆市卫生健康委医学科研项目（2022WSJK037） |
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| 中文摘要: |
| [摘要] 目的 探讨尿素解离试验在减少自身免疫性疾病患者新型冠状病毒（severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）IgM/IgG抗体假阳性中的应用价值。方法 选取2020 年2月1日—2021年2月28日在重庆市公共卫生医疗救治中心和重庆医科大学附属第一医院诊治的350例患者和健康体检者作为研究对象，其中自身免疫性疾病患者（自免组）200例、新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）患者（COVID-19组）100例和健康体检者（健康组）50例。采用胶体金免疫层析法和化学发光法检测SARS-CoV-2 IgM和IgG 抗体，对抗体阳性标本进行尿素解离试验。结果 健康组SARS-CoV-2 IgM和IgG抗体特异度均为100%（50/50）；自免组SARS-CoV-2 IgM和IgG抗体特异度分别为100%（200/200）和97%（194/200）；胶体金免疫层析法检测COVID-19组SARS-CoV-2 IgM和IgG抗体敏感度，分别为56%（56/100）和77%（77/100），IgM/IgG抗体总敏感度为85%（85/100）。尿素解离试验将自免组SARS-CoV-2 IgG抗体的特异度从97% （194/200）提高到 99.5%（199/200），将COVID-19组1例发病7 d内的弱阳性SARS-CoV-2 IgG抗体转为阴性。结论 尿素解离试验有助于减少自身免疫性疾病患者SARS-CoV-2 IgG抗体假阳性问题，但可能会影响其敏感度。 |
| 英文摘要: |
| [Abstract] Objective?To investigate the application value of urea dissociation test in reducing false-positive of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgM and IgG antibodies in patients with autoimmune diseases. Methods A total of 350 patients and healthy controls were consented and enrolled in the Chongqing Publi Health Medical Center and the First Affiliated Hospital of Chongqing Medical College in China from 1 February 2020 to 28 February 2021, the subjects were separated into 3 groups: patients with autoimmune diseases (autoimmune group, n=200), patients with coronavirus disease 2019 (COVID-19) (COVID-19 group, n=100) and healthy controls (healthy group, n=50). SARS-CoV-2 IgM and IgG antibodies were detected by colloidal gold immunochromatography, then the positive samples were subjected to urea dissociation test. Results The specificity of the SARS-CoV-2 IgM and IgG antibodies in healthy group were both 100% (50/50). While the specificity in autoimmune group were 100% (200/200) and 97% (194/200), respectively. The sensitivity was 56% (56/100) for detection SARS-CoV-2 IgM antibodies, and 77% (77/100) for IgG antibodies, and the total sensitivity of IgM and IgG antibodies was 85% (85/100). The specificity of the urea dissociation test for detection SARS-CoV-2 IgG antibodies in autoimmune group was increased from 97% (194/200) to 99.5% (199/200) . Additionally, 1 patient was detected within 7 days after onset in COVID-19 group, the result of SARS-CoV-2 IgG antibodies was detected by urea dissociation test from weakly positive turned to negative. Conclusions The urea dissociation test would be helpful for reducing false-positive of SARS-CoV-2 IgG antibodies in patients with autoimmune diseases, but it may affect the sensitivity of SARS-CoV-2 IgG antibody detection in COVID-19 patients. |
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