FQ-PCR技术在孕妇巨细胞病毒感染中的应用

Application of FQ-PCR in diagnosis and treatment of HCMV infected pregnancy

目的探讨孕妇血清人巨细胞病毒(HCMV)的数量与宫内感染率之间的关系以及中药热毒清的临床抗病毒疗效. 方法采用荧光定量聚合酶链反应(FQ-PCR)方法对68例HCMV-IgM阳性的晚期妊娠孕妇血清HCMV拷贝数进行检测,将其中57例DNA 阳性孕妇随机分成对照组(28例)和治疗组(29例),对其新生儿脐血以及中药热毒清治疗前后的HCMV拷贝数进行检测. 结果对照组28例中HCMV-DNA阳性孕妇血清HCMV-DNA拷贝数为0.085×104～5.4×108/ml,新生儿脐血DNA阳性9例,宫内传播率为32.1%(9/28),9例发生新生儿宫内感染的孕妇血清DNA拷贝数均大于1.86×105/ml;治疗组孕妇血清HCMV-DNA拷贝数0.068×104～4.2×108/ml,热毒清治疗后血清DNA拷贝数有显著下降(P＜0.01),宫内传播率为10.3%(3/29),与对照组比有显著性降低.结论孕妇血清中HCMV-DNA含量升高是胎儿发生HCMV感染的重要因素之一;中药热毒清能显著降低血清HCMV-DNA拷贝数,降低宫内传播率.FQ-PCR可以准确检测血清HCMV的含量,提示体内复制和宫内感染情况,对于临床诊断与治疗有一定的指导意义.

Objective To study the relationship of human cytomegelovirus（HCMV） level in serum of pregnant women with the rate of intrautrine infection and effectiveness of antiviral treatment of the traditional chinese medicine “Reduqing”, Methods The HCMV DNA copies in 68 third trimester pregnant women with HCMV-IgM positive were examined by fluorescent quantitative PCR（FQ-PCR） method. 57 cases with DNA positive were randomly assigned to control group （28 cases）and treatment group（29 cases） ,and HCMV DNA copies in their fetal umbilical blood before and after treatment with Reduqing were examined by FQ-PCR. Results In control group,9 out of 28 neonates were detected serum HCMV-DNA positive with 32.1% vertical transmission rate, whose mother＇s serum HCMV-DNA copies were all exceed 1.86× 10^5/ml. In treatment group, serum HCMV-DNA copies were 0. 068×10^4-4.2 × 10^8/ml with 10.3 % intrautrine infection rate, and decreased significantly （P〈0.01） after being treated with “Reduqing”. There were significant difference in the intrautrine infection rate between control group and treatment group. Conclusions Fetal exposure to high level of maternal HCMV-DNA is one of the important determininants of intrautrine infection. Both serum DNA copies and the intrautrine infection rate could be decreased significantly after being treated by Chinese traditional medicine “Reduqing”. FQ-PCR can evaluated serum HCMV viral load accurately,and be used to monitor the true state of HCMV infection and antiviral therapy.