不良妊娠结局与TORCH感染相关性的临床研究

Relationship between poor pregnancy outcome and TORCH infection in pregnant women

目的:探讨不良妊娠结局与妊娠期感染弓形体(TOX)、其他(OTH)、风疹病毒(RUV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV-Ⅱ)(TORCH)系列病原体的关系。方法:应用酶联免疫吸附试验(ELISA),检测48例有不良妊娠史的妇女(试验组)及48例正常孕妇(对照组)母血及胎儿脐血TORCH感染情况。结果:①试验组TORCH-IgG感染率分别为:TOX-IgG 14.58%,RUV-IgG 47.91%,CMV-IgG 45.83%,HSVⅡ-IgG 35.41%。②试验组TORCH-IgM感染率分别为:TOX-IgM 33.33%,RUV-IgM 52.08%,CMV-IgM 54.16%,HSVⅡ-IgM 58.33%。③试验组TORCH-IgG、IgM双项阳性发生率为:TOX 12.50%,RUV 37.50%,CMV 31.25%,HSV-Ⅱ18.75%。以上3个指标,试验组均显著高于对照组(P<0.01),不良妊娠结局发生率试验组亦显著高于对照组(P<0.01)。结论:TORCH系列病原体活动感染对围生儿预后会产生严重的不良影响,是导致妇女不良妊娠结局的重要原因之一,TORCH筛查应作为产前检查的常规项目。尤其对有不良妊娠结局史的妇女,行TORCH筛查对防止出生缺陷的发生是完全必要。

Objective： To investigate the relationship between history of abnormal pregnancy and TORCH infections in pregnant women, such as toxoplasma （TOX）, other （OTH）, rubella virus （RUV）, cytomegalovirus （CMV）, herpes simplex virus-Ⅱ（HSV-Ⅱ）. Methods： Enzymelinked immunosorbent assay （ELISA） combind with polymerase chain reaction （PCR） technique were used to detect TORCH infection in pregnant women with histories of abnormal pregnancies （study group, n=48） and normal pregnant women （control group, n=48） . The fetal cord blood samples were also detected. Results： In study group, the rates of previous TORCH infection： TOX-IgG 14. 58%, RUV -IgG 47. 91%, CMV-IgG 45.83%, HSV Ⅱ-IgG 35.41%. The rates of active infection： TOX-IgM 33.33%, RUV-IgM 52. 08%, CMV-IgM 54. 16%, HSV Ⅱ-IgM 58. 33%. The rates of recurrent infection： TOX 12. 50%, RUV 37.50%, CMV 31. 25%, HSV-Ⅱ18. 75%. These three kinds of infection＇rates in study group were significantly higher than that of control group （ P〈0.01 ） . The abnormal pregnant outcomes in study group were significantly higher than that of control group （ P〈0. 01 ） . Conclusion： TORCH series active infection is one of the important causes of abnormal pregnant outcomes. It is absolutely necessary to screen TORCH infection for women who had the histories of abnormal pregnancies in order to prevent birth defects and perinatal complications.