母亲巨细胞病毒DNA检测与新生儿感染的相关性研究

Relationship between human cytomegalovirus DNA in maternal milk and blood and neonate infection

目的研究产妇人巨细胞病毒(HCMV)感染乳汁与血液中病毒载量相关性,探讨乳汁HCMV检测在HCMV感染中的临床应用价值。方法采用荧光定量PCR(FQ-PCR)检测疑似HCMV感染的502例产妇乳汁及血液HCMV.DNA,并对其新生儿血清及尿液HCMV.DNA进行检测,观察新生儿的感染情况。结果 502例产妇乳汁阳性率12.15%,血液阳性率15.74%,两组阳性率差异无统计学意义(x^2=2.396,P>0.05),而血液中平均拷贝对数值高于乳汁中,差异有统计学意义(t=7.706,P<0.05),且乳汁与血液HCMV-DNA拷贝数对呈显著正相关(r=0.698,P=0.000)。502例疑似HCMV感染产妇的新生儿血液、尿液HCMV.DNA检测共63例阳性,阳性率12.55%。母乳HCMV阳性组与母乳HCMV阴性组、母血HCMV阳性组和母血HCMV阴性组比较,新生儿血液、尿液HCMV-DNA阳性检测率均升高(x^2值分别为438.69、63.71、407.48,均P<0.05)。结论巨细胞病毒感染孕产妇血液与乳汁的病毒栽量存在相关性,乳汁携带病毒为婴幼儿发生感染的重要原因。

Objective To study the relationship between human cytomegalovirus （HCMV） in maternal milk and blood and to explore the clinical application value of detecting HCMV in milk for HCMV infection. Methods Fluorescence quantitative PCR （FQ-PCR） was used to detect HCMV-DNA in milk and blood of 502 suspected cases, and HCMV-DNA in blood and urine of their newborns were also detected to observe neonatal infection. Results The positive rate was 12. 15% and 15.74% in maternal milk and blood, respectively, and the difference was significant （X2 = 2. 396, P 〉 0.05 ）. The average logarithm of copy in blood was significantly higher than that in milk （ t = 7. 706 ,P 〈 0.05 ）, and logarithm of copy in milk was positively correlated with that in blood （r = O. 698, P = 0. 000）. Of the neonates of these 502 suspected cases, 63 neonates were positive in HCMV-DNA detection in blood and urine with positive rate of 12.55%. The positive detection rate of HCMV in neonatal blood and urine increased significantly in maternal milk with positive HCMV group and in maternal blood with positive HCMV group compared with maternal milk with negative HCMV group and maternal blood with negative HCMV group （X2 value was 438.69, 63.71 and 407.48, respectively, all P 〈0.05）. Conclusion There is positive relation between virus load in blood and milk of HCMV infected puerperas. Milk carrying virus is the important reason for infant infection.