妊娠期弓形虫感染及妊娠结局的探讨

Study on fetuses and infants’ abnormalities induced by toxoplasmosis infection in pregnancy

【目的】 探讨孕妇弓形虫 (toxoplasmosis ,TOX)感染与胎婴儿先天感染和出生异常之间的关系。 【方法】 采用酶联免疫吸附试验 (enzymelinkedimmonosorbentassay ,ELISA)法和聚合酶链反应 (polymerasechainreac tion ,PCR)法分别检测 12 0 0例孕妇血清TOXIgM、TOXDNA。TOXDNA阳性孕妇其胎儿分娩 (包括流产 )时留取脐血 (或流产组织 )检测TOXDNA。 【结果】 孕妇TOXIgM阳性率为 6.3 3 % ,有不良孕产史者 12 .64 % ,明显高于正常妊娠 5 .2 1% ( χ2 =14 .3 7,P <0 .0 1)。垂直传播率为 3 7.10 % ,其中TOXIgM阳性组垂直传播率为 44 .68% ,明显高于阴性组 13 .3 3 % ( χ2 =4.79,P <0 .0 5 ) ,有不良孕产史组垂直传播率 5 7.14 % ,明显高于正常妊娠组 2 6.83 % ( χ2 =5 .47,P <0 .0 5 )。TOXIgM阳性组胎婴儿异常率 3 0 .2 6% ,明显高于阴性组 9.0 2 % ( χ2 =3 3 .73 ,P <0 .0 1)。 【结论】 孕妇弓形虫感染是导致胎婴儿发育异常的重要原因。

Objective To study the relationship between toxoplasmosis (TOX) infection in pregnant women and abnormalities of fetuses and infants. Enzyme linked immonosorbent assay(ELISA) and polymerase chain reaction(PCR) were respectively applied to detect TOX IgM、TOX DNA in the serum of 1 200 pregnant women.Detection of TOX DNA in cord blood (including abortive issues)when infants were delivered (including abortion)whose mothers were TOX DNA positive. Pregnant women TOX IgM positive rate was 6.33%, the TOX IgM positive rate of pregnant women with abnormal pregnancy history 12.64% was significantly higher than that of normal pregnancy 5.21%(χ 2=14.37,P<0.01). The rate of intrauterine transmission was 37.10%,the intrauterine transmissive rate of TOX IgM positive group 44.68% was significantly higher than that of negative group 13.33% (χ 2=4.79,P<0.05). The intrauterine transmissive rate of pregnant women group with abnormal pregnancy history 57.14% was significantly higher than that of normal pregnancy 26.83% (χ 2=5.47,P<0.05).Fetuses and infants’abnormal rate of TOX IgM positive rate 30.26% was significantly higher than that of negative group 9.02% (χ 2=33.73,P<0.01). [Conclusion] TOX infection in pregnant women is an important factor causing abnormalities of fetuses and infants.