巨细胞病毒IgG阳性育龄妇女体液阳性情况研究

Analysis on the cytomegalovirus shedding in different body fluid of women of reproductive age with positive serum CMV-IgG

目的:比较巨细胞病毒(CMV)IgG阳性育龄妇女外周血、尿液、阴道分泌物及乳汁中CMV排出情况,并探讨妊娠与体液排毒之间的关系。方法:应用酶联免疫吸附测定法对1 063例血清进行CMV IgG检测,阳性756例。对其中422例CMV IgG阳性的育龄妇女,应用实时荧光定量聚合酶链反应技术同时检测外周血白细胞、尿液、阴道分泌物中CMV DNA含量。22例孕妇随访至分娩,检测其乳汁中CMV排出情况。结果:422例CMV IgG阳性的育龄妇女中外周血白细胞、尿液、阴道分泌物CMV DNA检测的阳性率(1.4%、6.4%、13.7%)差异有统计学意义(χ2=48.615,P<0.01)。未妊娠妇女组、早期妊娠妇女组、中晚期妊娠妇女组分泌物CMV DNA阳性率(11.0%、14.4%、26.7%)差异有统计学意义(χ2=7.919,P=0.019)。随访的22例CMV IgG阳性孕妇有10例产后乳汁中检测出CMV DNA,阳性率为45.5%;孕期体液有CMV排出的孕妇分娩后乳汁中CMV的检出率高于孕期无体液排毒者。结论:对于CMVIgG阳性的育龄妇女,应重视无症状排毒情况,尤其重视对尿液、阴道分泌物以及产后母乳CMV排出的检测。

Objective：To compare the positive rate of cytomegalovirus（CMV） in blood,urine,vaginal secretion and breast milk in women of reproductive age seropositive for CMV and to discuss the relationship between pregnancy and shedding of CMV.Methods：CMV IgG of 1 063 women of reproductive age was serologically detected by ELISA.The viral load of CMV in the peripheral blood leukocytes（PBL）,urine and vaginal secretion of 422 women who were serologically positive was evaluated with real-time fluorescence quantitative PCR.A follow-up visit was performed in 22 pregnant women who were seropositive for CMV.CMV load in breast milk were detected after delivery.Results：The seropositive rate was 71.1%.The positive rate of CMV DNA detected in PBL,urine and vaginal secretion of 422 women were 1.4%,6.4% and 13.7% respectively,showing statistically significant difference（χ2=48.615,P=0.000）.There was statistically significant difference in the positive rate of CMV DNA detected in the vaginal secretion among women in the preconception group（11.0%）,the first trimester group（14.4%）,and the second and third trimester group（26.7%,χ2=7.919,P=0.019）.CMV DNA were found in the breast milk of 10 women after delivery（45.5%）.The detection rate of CMV DNA in breast milk was higher in women who had CMV shedding in body fluid during pregnancy.Conclusion：It should be put an emphasis on the asymptomatic CMV shedding to women who are seropositive,especially the detection of CMV DNA in urine,vaginal secretion and breast milk after delivery.