摘要
目的探讨新型冠状病毒IgM和IgG抗体筛查在孕妇保健中的应用价值。方法采用直接化学发光法对疫情期间来本院孕期保健的2 061例孕妇开展2019-nCoV IgM和IgG抗体筛查,阳性者采用胶体金免疫层析法进行复查。同时采集孕妇的咽拭子和粪便标本作新型冠状病毒核酸检测,取COVID-19治愈者生产时的胎盘组织做组织细胞病理学检查。结果直接化学发光法初筛检出血清新型冠状病毒IgM阳性4例,IgG阳性11例。用胶体金免疫层析法复核,仅1例COVID-19康复孕妇两种方法IgG均阳性。血清抗体阳性的15例孕妇咽拭子和粪便标本新型冠状病毒核酸检测均阴性,排除新型冠状病毒感染。检测COVID-19康复孕妇生产时的胎盘血及新生儿静脉血新型冠状病毒抗体IgG阳性,IgM阴性,胎盘组织、羊水、新生儿咽拭子及粪便标本新型冠状病毒核酸阴性。病理检查胎盘组织病理诊断绒毛膜板下炎及绒毛膜羊膜炎Ⅱ期Ⅲ级,脐带血管壁及间质内见中性粒细胞浸润(脐带炎)。结论筛查血清新型冠状病毒IgM和IgG抗体简便易行,可在孕妇保健中与核酸检测互补。COVID-19康复孕妇新生儿新型冠状病毒IgG阳性,胎盘炎症是否由新型冠状病毒感染引起尚缺乏证据。
Objective To explore the value of using screening for IgM and IgG antibodies to SARS-CoV-2 in health care for pregnant women. Methods Two thousand and sixty-one pregnant women who received prenatal care at this Hospital during the COVID-19 epidemic were screened for IgM and IgG antibodies to SARS-CoV-2 using direct chemiluminescence, and women testing positive were reexamined using colloidal gold immunochromatography. At the same time, throat swabs and fecal samples were collected from pregnant women to detect nucleic acids of SARS-CoV-2, and placental tissue of patients with COVID-19 at delivery was collected for histocytopathological examination. Results Four pregnant women were positive for IgM and 11 were positive for IgG according to direct chemiluminescence. Only one pregnant woman who recovered from COVID-19 was positive for IgG according to colloidal gold immunochromatography. A nucleic acid test for SARS-CoV-2 in throat swabs and feces from 15 pregnant women with positive serum antibodies was negative, and COVID-19 was excluded. The placental blood and neonatal venous blood of pregnant women who recovered from COVID-19 during delivery were found to be IgG-positive. IgM-negative placental tissue, amniotic fluid, neonatal throat swabs, and fecal samples were negative for SARS-CoV-2 nucleic acids. A histopathological examination of placental tissue and pathological examination of stage II chorionitis or stage III chorioamnionitis revealed neutrophil infiltration(inflammation of the umbilical cord) in the blood vessel walls and interstitium in the umbilical cord. Conclusion The screening of serum for IgM and IgG antibodies to SARS-CoV-2 is simple and can complement a nucleic acid test as part of prenatal care. The newborns of pregnant women who recovered from COVID-19 were IgG-positive, and there is no evidence that placental inflammation is caused by COVID-19.
作者
罗霞
蓝蔚蔚
项艳
张向东
陈颖
叶云
雷永良
陈秀英
LUO Xia;LAN Wei-wei;XIANG Yan;ZHANG Xiang-dong;CHEN Ying;YE Yun;LEI Yong-liang;CHEN Xiu-ying(Lishui Maternal and Child Health Hospital of Zhejiang Province,Lishui,Zhejiang 323000,China;Lishui Center for Disease Control and Prevention)
出处
《中国病原生物学杂志》
CSCD
北大核心
2021年第3期356-358,共3页
Journal of Pathogen Biology
基金
丽水市新型冠状病毒肺炎疫情防控科技攻关专项(No.2020KJGG04,2020KJGG05)。
关键词
新型冠状病毒
抗体检测
胎盘病理
SARS-CoV-2
antibody detection
placental pathology
