必需微量元素与孕期人巨细胞病毒感染相关性初步探讨

A Preliminary Study on the Relationship between Essential Trace Element and Human Cytomegalovirus Infection in Pregnancy

目的:探讨孕期必需微量元素与人巨细胞病毒(HCMV)感染的关系,初步研究缺锌与HCMV感染的相关性。为临床预防和治疗先天性HCMV感染,提供一定的理论及实验依据。方法:用ELISA和PCR相结合检测161名孕妇外周血特异性抗CMVIgM抗体、CMVDNA,检测出有活动性感染为病例组,无活动性感染为对照组。用原子吸收光谱法和荧光法测定其血清锌、铜、铁和硒含量。用双抗体夹心ELISA法检测孕妇外周血肿瘤坏死因子-α(TNF-α)水平。结果:①本研究中(秦巴山区)孕妇HCMV活动感染率19.25%;②病例组的血清锌含量明显低于对照组,差异有显著性(P<0.05)。病例组血清铜、铁、硒含量与对照组相比,差异无显著性(P>0.05);③病例组的TNF-α含量与对照组相比差异有显著(P<0.05);④对与孕期HCMV活动感染有关的因素,进行多元逐步回归分析,得出血清锌含量与HCMV感染相关性最强(β=0.375,P<0.01)。⑤血清锌含量与TNF-α含量有显著负相关(r=-0.571)。结论:秦巴山区孕妇HCMV感染率高于国内外报道;锌与该地区孕期HCMV活动性感染有明显相关性,缺锌导致TNF-α过多分泌,高水平的TNF-α诱导HCMV复制扩散的同时加剧了免疫抑制,使机体易感HCMV。因此对秦巴山区孕妇进行锌干预措施以预防和治疗先天HCMV感染,具有积极意义。

Objective：To explore the relationship between maternal blood level of essential trace elements （zinc, copper, iron and selenium） and human cytomegalovirus infection （HCMV） of pregnant women in Qinba mountain area. To preliminarily identify the correlation between zinc deficiency and cytomegalovirus infection during pregnancy. To provide certain theoretical and experimental data for the prevention and treatment of congenital cytomegalovirus infection.Methods：CMV- IgM and CMV DNA of 161 pregnant women in Qinba mountain area were detected by ELISA and PCR. 30 gravidas who had active HCMV infection were recruited as subject group （SG） and 130 gravidas who had tranquil infection were enrolled as control group （CG）. Serum zinc, copper, iron and selenium were （TNF-α） concentration was assessed by ELISA. Results：① The incidence of HCMV infection of pregnant women in OinBa mountain area was 19.25% which was significantly higher than that in domestic and foreign reports. ②Serum zinc concentration was significantly lower in SG than in CG （ P〈 0.05） but no significant difference in serum copper, iron and selenium was found between SG and CG（ P〉 0.05）.OSerum TNF-α concentration was higher in SG than in CG （P〈0.05）. ④By means of multifactodal regression analysis, the result showed serum zinc level had a significant correlation ~ HCMV infection. （β= 0.375, P〈 0.01 ）. ⑤Serum zinc concentration was found to have a negative correlation with TNF-α concentration （ r = - 0.571 ）. Conclusions： The incidence of HCMV infection of pregnant women in OinBa mountain area is significantly higher than those in domestic and foreign reports. Maternal blood zinc level is strongly correlated with HCMV infection during pregnancy, Zinc deficiency induces excessive secretion of TNF-α, high level of TNF-a enhances HCMV replication, and also leads to irnmunosuppression as well, thus increases human＇ s susceptibility to HCMV infection. It is imperative to supply zinc to gravidas in Qinba mountain area to prevent or treat HCM infection in pregnancy.