巨细胞病毒宫内感染的初步研究

Primary Study on Fetal Cytomegalovirus Infection

目的：寻找巨细胞病毒宫内感染产前诊断的途径。方法：应用酶联免疫吸附试验（ＥＬＩＳＡ）和聚合酶链反应（ＰＣＲ）技术，对２４例妊娠患有巨细胞病毒（ＣＭＶ）活动性感染的产妇，分娩的新生儿脐血抗ＣＭＶ－ＩｇＭ型抗体和羊水及尿液ＣＭＶ－ＤＮＡ进行检测。结果：２４例ＣＭＶ活动性感染孕妇中有１４例发生宫内感染，宫内感染率５８．３％，与对照组比较有高度显著性差异。宫内感染儿羊水ＣＭＶ－ＤＮＡ阳性率７８．６％，显著高于脐血ＣＭＶ－ＩｇＭ阳性率．孕妇尿液排毒状态与宫内感染的发生无明显关系。结论：宜将ＣＭＶ－ＩｇＭ阳性孕妇视为有宫内感染潜在危险的对象；羊水ＰＣＲ－ＣＭＶ检测可望成为产前诊断ＣＭＶ宫内感染的有效手段。

OBJECTIVES:To study the ways to prenatal diagnosis of fetal cytomegalovirus(CMV) infection.METHODS:Anti-CMV-IgM in cord blood and CMV-DNA in amniotic fluid or urine of newborns whose mothers had an active CMV infection in pregnancy were detected,respectively, by enzyme linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). RESULTS: Fetal CMV infection occurred in 58. 3% (14/24) of the pregnant women with active CMV infection,It was much higher than that of the control group. The positive rate(78. 6% )of PCR-CMV from amniotic fluid was apparently higher than that of CMV-IgM from cord blood in newborns with fetal infection. The state of urine CMV-draining of pregnant women had no apparent relation to fetal CMV infection. CONCLUSIONS: The pregnant women with CMV-IgM positive may be taken for the person at potential risk for fetal CMV infection,and detecting PCR-CMV from amniotic fluid is expected to be an effective method for prenatal diagnosis of fetal CMV infection.