胎儿血清β_2微球蛋白水平与宫内病毒感染的关系

Fetal serum β_2-microglobulin as a marker of congenital virus infection

目的评估胎儿血清β2微球蛋白水平与先天性巨细胞病毒感染和风疹病毒感染的关系。方法回顾性分析巨细胞病毒与风疹病毒感染胎儿血清的β2微球蛋白水平,并与病毒IgM阴性的对照组进行比较。β2微球蛋白水平的截断值为5mg/L。结果 15例先天性巨细胞感染的胎儿,有13例血清β2微球蛋白明显升高(敏感性为86.7%);35例对照组的血清中,有32例β2微球蛋白水平低于截断值(特异性为91.4%)。8例风疹病毒感染的胎儿,血清β2微球蛋白均明显升高(敏感性为100%);15例对照组的血清β2微球蛋白水平均低于截断值(特异性为100%)。病例组与对照组比较,均具有显著统计学意义。结论对于先天性巨细胞病毒和风疹病毒感染,胎儿血清β2微球蛋白可作为一种有效的辅助性标志物,对胎儿宫内感染的诊断与评估提供参考指标。

Objective： To evaluate the relationship between fetal serum β2 - microglobulin and congenital virus infection. Meth- ods： Cord blood samples from 23 positive subjects （cytomegalovirus in 15 cases and rubella virus in 8 cases） were retrospectively ana- lyzed for the level of fetal serum β2 - microglobulin by immunoturbidimetry method. The cut - off value of β2 - microglobulin was 5 mg/l. Results： Fetal serum was 〉5 mg/L （3.81 - 16. 81mg/L） in 13 of the 15 cases with proved fetal CMV infection, indicating 86. 7% sensitivity. In the 35 pregnancies with maternal seropositive but no laboratory signs of fetal infection, fetal serum β2 - micro- globulin was 〈5 mg/L in 32 cases, indicating 91.4% specificity. Fetal serum β2 - microglobulin was 〉5 mg/L （7.72 - 12. 81 mg/ L） in all 8 cases with proved fetal rubella virus infection, indicating 100% sensitivity. In the 15 pregnancies with maternal seropositive but no laboratory signs of fetal infection, fetal serum β2 -microglobulin was 〈 5 mg/L, indicating 100% specificity. Conclusion： Fetal serum β2 - microglobulin may be used as a predictor for congenital cytomegalovirus infection and rubella virus.