产前诊断先天性人巨细胞病毒感染安全性和可靠性分析

The Analysis of the security and reliability of the prenatal diagnosis for the congenital human cytomegalovirus infection

目的:探究宫内取材进行先天性人巨细胞病毒(HCMV)感染产前诊断的安全性和可靠性。方法:联合应用酶联免疫吸附试验(ELISA)、巢式PCR(N-PCR)和逆转录PCR(RT-PCR)分析武汉、上海和沈阳三地6723例育龄妇女和孕妇HCMV感染状况及妊娠结局。结果:育龄妇女活动性HCMVIgM检出率为6·11%,其中孕妇和非孕妇间无显著性差异。活动性感染孕妇绒毛、脐血HCMV感染率分别为51·52%、66·18%,明显高于对照组。先天性感染儿发生异常妊娠结局的危险性明显高于非感染儿。宫内取材所致妊娠丢失率均无显著增加,其检查结果与出生后的诊断一致。结论:宫内采集绒毛、羊水、脐血进行产前诊断,安全性和可靠性良好,可为胎儿的取舍提供依据。

Objective： To explore the security and reliability of the prenatal diagnosis by intrauterine sampling for the congenital HCMV infection, Methods, Enzyme - linked immunosorbent assay （ELISA） combined with nested - polymerase china reaction （ N - PCR）and reverse transcription -PCR （RT- PCR） technique were used to analyse the state of active HCMV infection and the pregnancy outcome in 6 723 cases of child - bearing - aged and pregnant women in Wuhan, Shanghai and Shenyang. Results： The positive rate of HCMV IgM antibody was 6. 11% and there was no difference between pregnant women and non -pregnant women. The infective rate in ehorionic villus and cord blood of the pregnant women with active infection was 51.52% and 66. 18% respectively, Both of them were significantly higher than that of the control group. The incidence of the abnormal pregnant outcome augmented prominently in the congenital infective fetus. The pregnant missing rate in the prenatal diagnostic group did not increase. The pre - and postnatal diagnostic results were identical. Conclusion ：The prenatal diagnosis by chorionic villus, amniotic fluid and/or cord blood is safe and reliable, and can provide some evidences for the decision of the acceptance or rejection of the fetus with congenital infection.