EBV及HCMV活动性感染与自然流产的关系探讨

Discussion on the relationship between EBV and HCMV active infection and spontaneous abortion

目的探讨EB病毒(EBV)、人巨细胞病毒(HCMV)活动性感染与自然流产的相互关系。方法选取我院2017年2月至2019年12月收治的120例自然流产孕妇作为观察组,另选取100例同期体检正常孕妇作为对照组。分析两组实验对象外周血EBV核心抗原(NA-IgG)、早期抗原(EA-IgM)、衣壳抗原(VCA-IgM)、衣壳抗体(VCA-IgG)、HCMV的DNA(HCMV-DNA)、IgM抗体(cMV-IgM),以及肿瘤坏死因子(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6)等炎性细胞因子水平差异,比较二者的相关性。结果两组实验对象的NA-IgG、VCA-IgG阳性率无显著差别,差异无统计学意义(P>0.05)。观察组患者的EA-IgM、VCA-IgM、HCMV-DNA、cMV-IgM阳性检出率显著高于对照组,二者比较差异有统计学意义(P<0.05)。观察组患者的TNF-α、IL-1、IL-6水平显著高于对照组,二者比较差异有统计学意义(P<0.05)。Spearman相关分析显示,EA-IgM、VCA-IgM、HCMV-DNA、cMV-IgM阳性与TNF-α、IL-1、IL-6水平均呈显著正相关(P<0.01)。结论EBV感染是自然流产的重要原因之一,HCMV感染会进一步引起孕妇免疫功能抑制,促使胎儿宫内感染并可能最终导致流产。

Objective To investigate the relationship between EB virus(EBV),human cytomegalovirus(HCMV)active infection and spontaneous abortion.Methods A total of 120 pregnant women with spontaneous abortion admitted to our hospital from February 2017 to December 2019 were selected as the observation group,and 100 pregnant women with normal physical examination during the same period were selected as the control group.The differences in peripheral blood EBV core antigen(NA-IgG),early antigen(EA-IgM),capsid antigen(VCA-IgM),capsid antibody(VCA-IgG),HCMV DNA(HCMV-DNA),IgM antibody(cMV-IgM),and inflammatory cytokines such as tumor necrosis factor(TNF-α),interleukin-1(IL-1),and interleukin-6(IL-6)between the two groups were analyzed,and the correlation between the two was compared.Results There was no significant difference in the positive rates of NA-IgG and VCA-IgG between the two groups of experimental subjects,and the difference was not statistically significant(P>0.05).The positive detection rates of EA-IgM,VCA-IgM,HCMV-DNA,and cMV-IgM in the observation group were significantly higher than those in the control group,and there was a statistical difference between the two(P<0.05).The levels of TNF-α,IL-1 and IL-6 in the observation group were significantly higher than those in the control group,and there was a statistical difference between the two(P<0.05).Spearman correlation analysis showed that EA-IgM,VCA-IgM,HCMV-DNA,cMV-IgM positive and TNF-α,IL-1,IL-6 levels were significantly positively correlated(P<0.01).Conclusion EBV infection is one of the important causes of spontaneous abortion.HCMV infection will further suppress the immune function of pregnant women,promote intrauterine infection of the fetus and may eventually lead to abortion.