IgG抗体亲和力指数在HCMV宫内感染中的临床评估

Clinical evaluation of immunoglobulin G avidity index in intrauterine infection to human cytomegalovirus.

【目的】用孕妇外周血人巨细胞病毒（human cytomegalovirus,HCMV）IgG抗体亲和力指数（avidity in-dex,AI）判断HCMV宫内感染的发生概率。【方法】ELISA法检测中晚期孕妇HCMV特异性抗体IgM和IgG,并对463例HCMV-IgM或HCMV-IgG阳性孕妇的胎儿或新生儿脐血进行HCMV-IgM检测;采用尿素变性试验检测孕妇IgG抗体亲和力指数。【结果】孕妇HCMV-IgM抗体阳性和IgG抗体阴性132例;HCMV-IgM和IgG抗体均阳性145例;HCMV-IgM抗体阴性和IgG抗体阳性186例。胎儿或新生儿HCMV-IgM阳性80例。原发性感染宫内感染率高于继发性感染（P〈0.01）,活动性感染宫内感染率高于非活动性（P〈0.01）,AI〈30%宫内感染率高于AI 30%-50%（P〈0.01）及AI〉50%（P〈0.01）。【结论】IgG抗体亲和力指数AI〈30%结合IgM阳性有助于提高判断HCMV宫内感染的发生率。

[Objective] To explore the action of IgG antibodies avidity index in intrauterine infection of pregenant women to human cytomegalovirus. [Method] HCMV-IgM or HCMV-IgG positive of 463 pregnant women in second or third trimester and their newborn infants/fetus were studied by ELISA assay, and HCMV-IgG antibodies avidity index of pregnant women were measured by urea denaturalization trial. [Results] In maternity,132 seras were founded HCMV IgM positive and HCMV IgG negative, HCMV-IgM positive and HCMV-IgG positive, 145 seras; HCMV-IgM negative and HCMV-IgG positive, 186 seras. In their newborn infants/fetus,80 seras were also found HCMV IgM positive. Intrauterine infection rate of primary infection was higher than that of recurrent infection （P〈0.01）, Intrauterine infection rate of activity infection was higher than that of stillness infection（P〈0.01）. Intrauterine infection rate of AI〈30 % was higher than that of Al 30% -50% （P〈0.01） or AI〉50%（P〈0.01）. [Conclusion] Combination of HCMV-IgG antibodies a vidity index （AI〈30 %） and HCMV-IgM positive may be helpful for diagnosis of intrauterine infection.