新型冠状病毒肺炎患者血清抗ACE-2抗体表达及其影响因素分析

doi:10.3969/j.issn.1673-8640.2023.12.007

摘要/Abstract

摘要：

目的探讨新型冠状病毒肺炎（COVID-19）患者血清抗血管紧张素转换酶-2（ACE-2）抗体的表达情况及其影响因素。方法选取2023年2—4月同济大学附属东方医院COVID-19患者196例（COVID-19组），其中感染期患者156例（感染期组）、康复期患者40例（康复期组）；以同期未感染新型冠状病毒（SARS-CoV-2）的健康体检者12名作为正常对照组。收集所有研究对象的临床资料，并检测抗ACE-2抗体和抗SARS-CoV-2 IgG抗体。采用Logistic回归分析评估抗ACE-2抗体表达的影响因素。结果与正常对照组比较，感染期组和康复期组血清抗ACE-2抗体吸光度（A）值显著升高（P<0.05）；轻型、普通型、重型和死亡COVID-19患者的血清抗ACE-2抗体A值均显著升高（P<0.05），其中死亡患者血清抗ACE-2抗体A值最高。男性患者血清抗ACE-2抗体A值高于女性患者（P<0.05）。住院>27 d的患者血清抗ACE-2抗体A值显著高于住院≤27 d的患者（P<0.05）。感染期的住院患者与门诊患者之间血清抗ACE-2抗体A值差异无统计学意义（P>0.05）。在普通型COVID-19患者中，住院患者血清抗ACE-2抗体A值高于门诊患者（P<0.05）。普通型、重型、死亡、轻型、康复期COVID-19患者抗ACE-2抗体阳性率分别为22.22%、27.50%、38.71%、31.82%、2.50%。Logistic回归分析结果显示，抗SARS-CoV-2 IgG抗体阳性和高龄是抗ACE-2抗体阳性的影响因素[比值比（OR）值分别为0.115、1.047，95%可信区间（CI）分别为0.039~0.346、1.005~1.091]。结论血清抗ACE-2抗体与COVID-19患者病情严重程度密切相关。年龄和抗SARS-CoV-2 IgG抗体均是抗ACE-2抗体表达的影响因素。

关键词: 血管紧张素转换酶-2, 自身抗体, 新型冠状病毒肺炎, 新型冠状病毒

Abstract:

Objective To investigate the expression of anti-angiotensin-converting enzyme-2（ACE-2） antibody in patients with corona virus disease 2019（COVID-19） and its risk factors. Methods A total of 196 COVID-19 patients（COVID-19 group） were enrolled from Shanghai East Hospital of Tongji University from February to April 2023，which included 156 patients with infection（infection group） and 40 patients with recovery（rehabilitation group）. Totally，12 healthy subjects who were not infected with severe acute respiratory syndrome coronavirus 2（SARS-CoV-2） during the same period were enrolled as control group. The clinical data of all the subjects were collected，and anti-ACE-2 antibody and anti-SARS-CoV-2 IgG antibody were determined. Logistic regression analysis was used to evaluate the risk factors for anti-ACE-2 antibody. Results Compared with control group，the absorbance（A） value of anti-ACE-2 antibody in infection and rehabilitation groups were increased（P<0.05）. The A value was increased in mild，common，severe patients and dead patients with COVID-19（P<0.05），and that in dead group was the highest. The A value for serum anti-ACE-2 antibody in male patients was higher than that in female patients（P<0.05），and that in patients hospitalized for >27 d was higher than that in patients hospitalized for ≤27 d（P<0.05）. There was no statistical significance in serum anti-ACE-2 antibody A value between inpatients and outpatients during the infection period（P>0.05）. The anti-ACE-2 antibody level in inpatients was higher than that in outpatients in common group（P<0.05）. The positive rates of anti-ACE-2 antibody were 22.22% in common patients，27.50% in severe patients，38.71% in dead patients，31.82% in mild patients and 2.50% in recovery patients. Logistic regression analysis showed that the positive IgG of anti-SARS-CoV-2 antibody and increasing age were influencing factors for positive anti-ACE-2 antibody [odds ratios（OR） were 0.115 and 1.047，and 95% confidence intervals（CI） were 0.039-0.346 and 1.005-1.091，respectively]. Conclusions Anti-ACE-2 antibody is related to the severity of COVID-19 patients. Both age and anti-SARS-CoV-2 IgG antibody are influencing factors associated with anti-ACE-2 antibody.

Key words: Angiotensin-converting enzyme-2, Autoantibody, Coronavirus disease 2019, Severe acute respiratory syndrome coronavirus 2

中图分类号:

R446.1

成宇, 徐臻, 陆柳, 丁梦蕾, 虞珊珊, 宗明, 范列英. 新型冠状病毒肺炎患者血清抗ACE-2抗体表达及其影响因素分析[J]. 检验医学, 2023, 38(12): 1147-1152.

CHENG Yu, XU Zhen, LU Liu, DING Menglei, YU Shanshan, ZONG Ming, FAN Lieying. Expression and risk factors of anti-ACE-2 antibody in serum of patients with COVID-19[J]. Laboratory Medicine, 2023, 38(12): 1147-1152.

图/表 5

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项目	β值	OR值（95%CI）	P值
性别	-0.272	0.762（0.297~1.954）	0.572
高血压史	0.191	1.211（0.286~5.133）	0.795
糖尿病史	-0.003	0.997（0.321~3.090）	0.995
抗SARS-CoV-2 IgG抗体	-2.159	0.115（0.039~0.346）	0.000
吸烟	-0.425	0.654（0.176~2.430）	0.526
年龄	0.046	1.047（1.005~1.091）	0.027
基础疾病	1.321	3.748（0.584~24.059）	0.164

项目	β值	OR值（95%CI）	P值
性别	-0.272	0.762（0.297~1.954）	0.572
高血压史	0.191	1.211（0.286~5.133）	0.795
糖尿病史	-0.003	0.997（0.321~3.090）	0.995
抗SARS-CoV-2 IgG抗体	-2.159	0.115（0.039~0.346）	0.000
吸烟	-0.425	0.654（0.176~2.430）	0.526
年龄	0.046	1.047（1.005~1.091）	0.027
基础疾病	1.321	3.748（0.584~24.059）	0.164