摘 要 为进一步研究HFRS免疫损伤机制，用ELISA法同步测定了108例不同临床型、不同病日、病期HFRS患者血清中特异性IgA、IgE抗体以及HFRS病毒特异性IgA、IgE型CIC的水平及检出率。发现HFRS-IgA型抗体在轻型病例高于中、重型病例；HFRS-IgE型抗体及IgE型CIC在重型病例高于中、轻型病例。上述差异在病程早期(发热、休克少尿期，或是3～8病日)尤为突出。IgA型CIC则未见到上述差异。
Studies on Detection of Serum Specific IgA, IgE Antibodies and Circulation Immune Complexes in Patients of Hemorrhagic Fever with Renal Syndrome
Zhang Donghai
(Zibo Central Hospital. Zibo.Shandong Province 255036)
Sun Hui Gao Feng
(Zibo Second Health School)
Abstract Detection had been made for the levels of serum specificity IgA, IgE antibodie and specificity of virus antigens circulation immune complexes (CIC) on the different days or phases of illness and clinic types in patients of HFRS. The results showed that the level of specific IgA antibody was higher in slight cases than in middle and severe; specific IgE antibody and its CIC was higher in severe cases than in slight and middle. Those differences were apparent in acute phase (illness phase of fever and shock-oilguria, or 3-8 days after illness). But specific CIC IgA types had no diferences.
Key words Hemorrhagic Fever with Renal Syndrome (HFRS), Specific IgA antibody, Specific IgE antibody, Circulating Immune Complexes (CIC), ELISA
对肾综合征出血热(HFRS)免疫发病机理研究较多的是IgG、IgM、IgE型抗体[1～4]。已有报告在HFRS患者血清中可检测到特异性IgA抗体[5～6]。为进一步了解HFRS患者发病过程中特异性抗体及其循环免疫复合物的形成及其致病性，我们平行测定了特异性IgA、IgE抗体以及抗原特异性IgA、IgE型循环免疫复合物(CIC)的水平，并从临床分型、病期、病日等角度作了对比分析。
1 材料与方法
1.1 HFRS病人血清 采集本市54例HFRS病人进出院时血清共108份。IgA型检测108份，IgE型检测其中93份。血清病期、病型分布见表1。
表1 待测血清病期、病型分布
Table 1 Phases and types of illness for collected sera
病期
phase of illness 轻
slight 中
middle 重
severe 合计
total
发热 fever (18) 16 (18) 17 (2) 2 (38) 35
休克少尿 shock & oilguria (1) 0 8 (7) (5) 5 (14) 12
多尿 polyuria (8) 6 (14) 11 (3) 3 (25) 20
恢复 recovery (15) 12 (12 )11 (3) 4 (31) 26
合计 TOTAL (42) 34 (52) 46 (14) 13 (108) 93
注： ( )外为IGE型，( )内为IGA型检测血清数。
NOTE: THE NUMBERS OUT OF THE PARENTHESIS ARE THE TYPES OF IGE ANTIBODY TESTED AND IN THE PARENTHESIS ARE THE NUMBERS OF TESTED IGA.
1.2 试剂
1.2.1 兔抗HFRS血清及鼠脑HFRS抗原 卫生部中国药品生物制品检定所俞永新教授惠赠。
1.2.2 兔抗人IGE抗体购自DAKO公司。
1.2.3 鼠抗人IGA抗体及HRP-鼠抗人IGA抗体 系中国医科院基础研究所产品。
1.2.4 HRP-鼠抗HFRS 小鼠腹水系南京军区总院产品，纯化后标记HRP(RZ=3.0)。
1.3 实验方法
1.3.1 检测HFRS-IGA、IGE抗体 采用改良抗体捕获ELISA技术[5]。即包被抗人IGA或IGE-MCAB→病人血清→HFRSV-AG HRP-抗HFRS。