秦巴山区人巨细胞病毒gN基因型分布及其与宫内感染的关系

Relationship between vertical transmission of HCMV infection and HCMV gN genotypes in Qinba mountain areas

目的探讨陕西秦巴山区母婴人巨细胞病毒(HCMV)感染流行株的包膜糖蛋白gN基因型分布及其与HCMV宫内感染结局的相关性。方法采用ELISA法检测434例孕期妇女血清中HCMV-Ig M及HCMV-IgG,判断秦巴山区孕期妇女HCMV感染情况;采用PCR方法检测孕妇血清和新生儿尿液中的HCMV gN基因,利用限制性核酸内切酶SacⅠ、SalⅠ和ScaⅠ分别对HCMVgN基因进行限制性片段长度多态性(RFLP)分析。结果①434例孕妇血清中HCMV-Ig M阳性35例,阳性率8.06%;HCMVgN DNA阳性25例,阳性率为5.76%。新生儿尿液中HCMVgN DNA阳性17例,阳性率为3.92%。在35例HCMV-Ig M阳性孕妇中,其配对新生儿尿液HCMV gN DNA阳性11例,HCMV宫内传播率为31.43%。②42例HCMV gN DNA阳性标本(25例孕妇及17例新生儿)gN3型2例、gN4型40例,8例症状性HCMV感染婴儿与8例无症状性感染婴儿及其母亲均具有相同的基因型gN4型;1例病理性黄疸患儿与其母亲基因型为gN3。③新生儿感染症状及预后与基因型之间无相关性。结论陕西秦巴山区母婴HCMV流行株以gN4型为主。gN3、gN4基因型可引起母婴传播。

Objective To assess the distribution of human cytomegalovirus（HCMV） glycoprotein N（gN） genotypes in the maternal and infant HCMV infected population in Qinba mountain areas of Shaanxi Province,and to explore the possible relationship between genotypes and clinical outcome of intrauterine HCMV infection.Methods Serum HCMV-IgM and HCMV-IgG levels were detected by ELISA in 434 pregnant women to determine HCMV infection in pregnant women in Qinba mountain areas.HCMV gN was detected by PCR in the 434 pairs of mother and infant,and gN genotypes were analyzed by restriction fragment length polymorphism（RFLP） analysis.Results ① HCMV-IgM positive rate in sera was 8.06%（35/434） in the pregnant women,and 3.92%（17/434） in the neonates.In the 35 pregnant women with positive HCMV-IgM,11 were confirmed infected with HCMV in their children urine.The rate of transplacental transmission of HCMV was 31.43 %（11/35）.② Of the 42 cases 40 were grouped into the gN genotype 4,including 8 symptomatic infected infants and 8 asymptomatic infants and their mothers;1 infant with pathological jaundice and his mother were grouped into the gN genotype 3.③ There was no correlation between genotypes and the symptoms and prognosis of neonatal infection.Conclusion HCMV gN genotype 4 is a major genotype in maternal and infant infections in Qinba mountain areas of Shaanxi Province;gN3 and gN4 may cause mother-to-infant transmission.