围孕期选择性TORCH筛查的临床意义

Clinical significance of selective TORCH antibody screening for progestational and pregnant women

目的:调查围孕期不同人群TORCH感染的发生率,了解育龄人群的TORCH自然免疫情况,探讨围孕期选择性TORCH筛查的临床意义。方法:采用酶联免疫检测(EIA)法,检测4085名孕前咨询者和不同孕周孕妇血清TORCH抗体水平,采用相对数、卡方检验分组统计,比较不同人群血清抗体阳性率。结果:TORCH抗体阳性率在孕前男、女性无明显差别;女性TORCH抗体检测结果,在早孕期组抗体阳性率均较孕前组高,但差异无显著性;没有宠物接触史、感冒、感染症状的孕妇中,TORCH-IgM抗体、TOX-IgG抗体均为阴性;而有宠物接触史、感冒、感染症状的孕妇中,TORCH-IgM抗体阳性率分别是:TOX-IgM42·86%、RUB-IgM1·37%、CMV-IgM6·58%、HSV-IgM77·42%;两组孕妇的RUB、CMV、HSV-IgG抗体阳性率无明显差异。结论:临床上可对孕前育龄妇女、有宠物接触史、感冒、感染症状的孕妇选择性地进行TORCH筛查,以减少胎儿宫内感染的风险。

Objective： To investigate the infection rate of TORCH in different populations during progestation and pregnancy and understand the immune condition of TORCH in adults at child - bearing age, and to evaluate the significance of selective TORCH antibody screening for progestational and pregnant women. Methods： Totally 4 085 subjects were enrolled in this study. Serum TORCH antibody were tested by ELA. The data were statistically analyzed using relative numbers and x^2 test, compared the positive rate of serum antibody in different populations. Resultsl There were similar TORCH antibody positive rates between progestational women and men groups. A higher TORCH antibody positive rate was found in first trimester pregnant women than that in the progestafional women group, but no statistical difference was found between the two groups. Pregnant women who without pet contact history, influenza and infectious symptom were negative for TORCH IgM and TOX - IgG antibodies, whereas, the serum IgM antibody positive rates were TOX - IgM 42. 86% , RUB - IgM 1.37%, CMV - IgM 6.58%, HSV - IgM 77.42%, respectively, in pregnant women who with pet contact history, influenza and infectious symptom. There were no statistical differences of antibody positive rate for RUB, CMV, HSV - IgG between the two groups. Conclusion： Carrying out selective TORCH screening in pre - pregnant women of child - bearing age and pregnant women who with pet contact history, influenza and infectious symptom is important to reduce the risk of fetus intrauterine infection.