宫内人巨细胞病毒感染的前瞻性研究

A PROSEPECTIVE STUDY OF THE INFLUENCE OF THE CONGENITAL HCMV INFECTION ON THE QUALITY OF FETUS AND NEONATES

应用ＥＬＩＳＡ方法及聚合酶链反应，对１８１８例孕母及其婴儿进行孕期人巨细胞病毒（ＨＣＭＶ）感染的母婴间宫内传播的前瞻性研究。结果表明：孕母ＨＣＭＶ－ＩｇＧ阳性率为８９．２％；孕母ＨＣＭＶ活动性感染率为４．５％，孕早、中、晚各期ＨＣＭＶ活动性感染率分别为２．４％、３．５％、１．９％，其中原发感染略高于１．１％，提示孕期大多数孕妇为复发感染；孕母ＨＣＭＶ抗体在孕期有阳转或阴转的不同变化；孕母不仅ＨＣＭＶ－ＩｇＭ阳性可感染胎儿，即使ＨＣＭＶ－ＩｇＧ阳性、ＩｇＭ阴性，其子仍有感染ＨＣＭＶ可能，ＨＣＭＶ－ＩｇＧ抗体对胎儿不能完全起保护作用；提示应用ＥＬＩＳＡ和ＰＣＲ技术对ＨＣＭＶ母婴传播进行诊断，对于早期干预及改善预后有极重要的作用，有必要对先天性ＨＣＭＶ感染儿进行长期随访。

818 pregnant women and their infants in Yang-pu District Shanghai were studied withthe ELISA and PCR techniques prospectively to determine the state of congenital HCMV in-fection. The results indicated that the maternal HCMV-IgG seropositive rate was 89.2%,whereas the maternnal active infection rate was 4.5% with that of 2.4%,3.5%,1.9%forthe three trimesters respectively. The primary maternal infections accounted for only 1.1%,which indicated that the majority maternal infections were recurrent infections. The maternalHC MV-IgG antibodies underwent a variable seroconversion during pregnancy which showed20.5%positive-conversion rate and 1.0 %negative-conversion rate,The presence of maternal HCMV-IgG antibodies did not prevent the transmission of HCMV from mother to the fe-tus,We concluded that the diagnosis of the congenital HCMV infection using the ELISA andthe PCR techniques played a significant role in the early intervention and the consequent im-proving of the disease. Long term follow up of those infected infants was necessary.