流产死胎组织中的巨细胞病毒、弓形虫感染监测

DETECTION OF CYTOMEGALOVIRUS AND TOXOPLASMA GONDII INFECTION IN FETAL TISSUES OF ABORTION AND STILLBIRTHS

本文通过人巨细胞病毒（ＨＣＭＶ）分离、套式聚合酶反应（ＰＣＲ）及限制酶切分析、弓形虫分离及一次ＰＣＲ，对不明原因的流产、死胎组织进行ＨＣＭＶ及弓形虫检测。结果发现，２８份流产、死胎组织中，１例死胎肺组织ＨＣＭＶＤＮＡ阳性，病毒分离阴性；１例胎儿心、肺、脑、肝、肾、眼组织弓形虫ＤＮＡ阳性，其脑、肺、眼、肝组织经动物接种后，在小白鼠腹水中找到弓形虫滋养体，但心、肾结果阴性。提示：临床上有些不明原因的流产、死胎是由于胎儿感染ＨＣＭＶ或弓形虫所致。ＰＣＲ技术较常规病原体分离敏感、快速，适合于ＨＣＭＶ／弓形虫感染所致流产、死胎的早期诊断。

Human cytomegalovirus (HCMV) and Toxoplasma gondii(Tox) were detected in tissues of abortions and stillbirths.Diagnostic methods involved virus isolation,nested PCR,restriction endonucleases analyses of HCMV and the etiological isolation of Tox-trophozoites through mice inoculation and single PCR to Tox.The results showed that,among 28 stillbirths and abortions,HCMV DNA was found in the lung tissue of one fetal death,which was negative in virus isolation.Tox DNA was positive in all tissues of a stillbirth including the heart,lungs,brain,liver,kidney,and eye tissues.Tox tachyziotes was isolated from the brain,lung,eye and liver tissues in the fetal death through animal inocuation,but negative results were seen in the heart and kidney.All these suggests that some abortions and stillbirths result from fetal infection with HCMV or Tox.PCR,being more sensitive and rapid than pathogen isolation,might be useful for early diagnosis of abortions and stillbirths with HCMV or Tox infection.