新生儿早期TOX、CMV、RV的血清学检测结果分析

Serological screening for early infection of toxplasma,cytomegalovirus and rubella virus in neonates

目的分析新生儿早期弓形虫病毒(TOX)、巨细胞病毒(CMV)、风疹病毒(RV)的感染情况和临床特点。方法对2008年1月至2009年5月本院新生儿科住院的490例可疑新生儿早期患者采用化学发光法进行TOX、CMV、RV抗体的检测,仪器为美国ABBORT公司AXSYM全自动化学发光仪。结果 TOX-IgG阳性18例(3.67%),TOX-IgM阳性0例(0%);CMV-IgG阳性242例(49.38%),CMV-IgM阳性16例(3.26%);RV-IgG阳性364例(74.28%),RV-IgM阳性2例(0.41%);以IgM阳性视为宫内感染,新生儿早期感染以CMV和RV为主,未见TOX感染;临床特点以高胆红素血症、肝功能异常、新生儿肺炎、胎儿发育迟缓、贫血、先天畸形及神经系统损害为主。结论 CMV为新生儿早期先天性病毒感染的主要病原体,临床特点多样化,可造成新生儿多系统损害,危害性大,对可疑新生儿早期患者应尽早进行检测,以获早期诊治。

Objective：To explore the rate of early infection of toxplasma （TOX）,cytomegalovirus （CMV） and rubellavirus （RV） in neonates and to study the clinical characteristics of the infections. Methods：Serum antibodies against TOX,CMV and RV were measured in 490 cases of suspectedly early infected neonates hospitalized in our hospital during January,2008 to May,2009 by Chemiluminescence Immuno Assays with an Abbott AxSym Chemistry Analyzer. Results：Among the 490 cases of suspectedly neonate infection,18 cases were found positive for TOX-IgG （3.67%）,no sample positive for TOX-IgM （ 0%）,242 cases positive for CMV-IgG （49.38%）,16 cases positive for CMV-IgM （3.26%）,364 cases positive for RV-IgG （74.28%）,and 2 cases positive for RV-IgM （0.41%）,respectively. IgM positivity taken as hallmark of uterus infection,infection in neonates were dominated by CMV and RV whilst infection by TOX rarely observed in our cohort. The infection was clinically characterized by hyperbilirubinemia,liver malfunction,neonatal pneumonia,retarded neonatal development,anemia,congenital malformation,and damages to the nerve system. Conclusion：Our results demonstrated that CMV was the major pathogen of early neonatal virus infection which was characterized by variable clinical features and multi-system damages to neonates. It＇s suggested to perform earlier detection for CMV infection in suspectedly infected neonates for a earlier recovery.