应用荧光杂交定量PCR和ELISA法进行产前TORCH筛查比较研究

Comparing of TORCH screening between fluorescent hybridization quantitative PCR and ELISA.

目的:比较荧光杂交定量PCR和ELISA法进行产前TORCH筛查的差异,探讨病原微生物拷贝数在临床诊治中的作用.方法:分别用荧光杂交定量PCR和ELISA IgM法筛查272例孕期血标本(妊娠早期102例、晚期170例);121例分娩母血及新生儿脐带血标本;222例不明原因流产血标本,其中66例采集了新鲜自然流产脱膜和绒毛.结果:孕期筛查血CMV DNA和TOX DNA的阳性率分别为1.8%(5/272)和0.36%(1/272).其中妊娠早期CMV DNA的阳性率为2.9%(3/102),晚期为1.2%(2/170).不明原因流产者,查出血清CMV感染者22例,TOX4例,CMVDNA和TOX DNA的阳性率分别为9.9%(22/222)和1.8%(4/222).脱膜和绒毛均感染者3例,1例血清、脱膜感染但未采到绒毛标本,2例孕母血清中查到CMV,而流产组织中未查到.查出血清、脱膜和绒毛均感染TOX者1例.妊娠妇女外周血CMV DNA≥103有88%发生流产.结论:荧光杂交定量PCR法不但具有较高的灵敏度和特异性,而且可检测病毒负载量-拷贝数/ml,拷贝数越高发生流产的可能性愈高,应推荐作为妊娠初期筛查的首选方法.

Objective: In order to know the clinical value of microorganism DNA copy the difference of prenatal TORCH screening was compared between fluorescent hybridization quantitative PCR and ELISA. Method;272 cases blood samples from pregnant women(early pregnancy 102 cases,late pregnancy 170 cases )were screened by fluorescent hybridization quantitative PCR and ELISA. 121 blood samples of mothers and newboms cords were collected. Among 222 unexplained abortion patients 66 fresh decidua and villi were collected. Result;The positive rate of CMV DNA and TOX DNA was 9.9% (5/272) and 0. 36% (1/272) respectively. The positive rate of CMV DNA during early pregnancy was 23. 9% (3/102) , 1. 2% (2/170) during late pregnancy. 22 CMV and 4 TOX serum infection were found among unexplained abortion patients, the positive rate of CMV DNA and TOX DNA was 9. 9% (22/222) and 1. 8% (4/222) respectively. 3 women got decidua and villi infection,1 woman got serum and decidua infection without obtaining villi sample. CMV was detected in serum of 2 pregnant women butnot in the abortion tissue. 1 woman got serum, decidua andvilli TOX infection. When CMV -DNA copy was ≥103, almost 88% pregnant women would suffer abortion. Conclusion: Fluorescent hybridization quantitative PCR not only have high sensitivity and specialty of virus quantity, is copy /ml,the higher the copy number detected the more possibility of abortion. This method should be suggested as first choice in early pregnancy screening.