子痫前期与巨细胞病毒、肺炎衣原体及单纯疱疹病毒2型感染关系的探讨

Relationship of cytomegalovirus, Chlamydia pneumoniae and herpes simplex virus type 2 infections with preeclampsia

目的探讨子痫前期与炎症反应及巨细胞病毒（CMV）、肺炎衣原体（CP）、单纯疱疹病毒2型（HSV-2）的关系。方法选择2011年6至11月于首都医科大学附属北京妇产医院住院的妊娠晚期子痫前期患者52例和正常孕妇34名为研究对象。所有病例均为单胎妊娠并排除发动宫缩、胎膜早破、有症状的感染性疾病、糖尿病、慢性高血压、肾病、近期使用抗生素或激素者。采用酶联免疫吸附测定法检测孕妇血清中病原体（CMV、CP、HSV-2）IgM和IgG抗体的水平，以及超敏C-反应蛋白（hs-CRP）和白细胞介素（IL）_6的浓度。结果（1）子痫前期组CMV和HSV-2的IgM抗体阳性者各1例，对照组分别为2例及3例，两组cP均为阴性。子痫前期组CMV、CP、HSV-2的IgG抗体阳性率分别为94．2％（49／52）、53．8％（28／52）及3．8％（2／52）；对照组分别为100．O％（34／34）、55．9％（19／34）及5．9％（2／34），差异无统计学意义（P〉0．05）。（2）子痫前期组IL-6及hs．CRP的浓度分别为（7．2±2．1）ng／L及（6．8±5．6）mg／L；对照组分别为（6．2±1．8）ng／L及（4．6±3．0）mg／L，差异均有统计学意义（均P〈0．05）。结论子痫前期患者存在过度炎症反应，但在血清学上并未发现子痫前期与病原体（CMV、CP、HSV-2）存在相关性。

Objective To explore the potential relationship of cytomegalovirus （CMV）, Chlamydia pneumoniae （CP） and herpes simplex virus type 2 （HSV-2） in inflammation and preeclampsia. Methods Fifty-two pregnant women with preeclampsia and 34 with uncomplicated pregnancy in the third trimester were recruited. The exclusions included uterine contractions, multiple pregnancies, rupture of membranes, symptomatic infectious diseases, medical diseases and antibiotics or hormones users. Samples of maternal blood were harvested from two groups. Serum levels of CMV, CP, and HSV-2 IgM and IgG antibodies as well as high-sensitivity C-reactive protein （hs-CRP） and interleukin-6 （IL-6） were determined by enzyme- linked immunosorbent assay （ELISA） in preeclampsia and normal pregnancy controls. Results （ 1 ） Recent infections of CMV, CP and HSV-2 were not more common in patients with preeclampsia versus normal pregnancy. The prevalence rates of long-dated CMV, CP and HSV-2 infection were 94. 2% （49/52） ,53. 9% （28/52） and 3.9% （2/52）in preeclampsia group versus 100.0% （34/34）, 55.9% （19./34）and 5.9% （2/34） in control group. No significant difference existed between two groups （ P 〉 0. 05 ）. （2） Maternal serum concentrations of IL-6 and hs-CRP in patients with preeclampsia were significantly higher than that in normal pregnancy women （ （7. 2 ± 2. 1 ） ng/L and （ 6. 8 ± 5.6 ） mg/L vs （6. 2 ±1. 8 ） ng/L and （4. 6 ± 3.0） mg/L, both P 〈 0. 05 ）. Conclusion Excessive inflammatory reactions are present in women with preeclampsia. But previous infections, as measured by IgM and IgG antibody seropositivity to CMV, CP and HSV-2, are not correlated with preeclampsia in the third trimester.