北京地区育龄期妇女TORCH筛查结果调查分析

Analysis on TORCH Screening Results among Women at Childbearing Age in Beijing

目的通过化学发光免疫分析法(CLIA)检测北京地区育龄期妇女血清TORCH IgM和IgG抗体(anti-TORCH),并对结果进行分析,为本地区孕妇保健提供参考依据。方法选取2012年11月—2013年11月在北京大学人民医院进行孕前筛查和孕期普查的妇女共6 978例,采用CLIA进行血清anti-TORCH检测。结果与其他3种病原体比较,单纯疱疹病毒Ⅰ/Ⅱ抗体IgM(anti-HSVⅠ/ⅡIgM)的阳性检出率最高,为11.19%(779/6 962)(P<0.007);其次为风疹病毒抗体IgM(anti-RV IgM)和巨细胞病毒抗体IgM(anti-CMV IgM),阳性检出率分别为2.63%(176/6 691)、2.54%(167/6 564),二者阳性检出率间无差异(P=0.755);弓形虫抗体IgM(anti-TOX IgM)的阳性检出率〔0.62%(41/6 601)〕较其他3组低(P<0.007)。anti-CMV IgM以秋季为高发期〔阳性检出率为3.66%(54/1 475),P<0.007〕;anti-HSVⅠ/ⅡIgM以春、秋两季为高发期〔阳性检出率分别为12.48%(280/2 244)和12.41%(195/1 571),P<0.007〕,但春、秋两季比较无差异(P>0.05);anti-TOX IgM、anti-RV IgM在不同季节的阳性检出率比较无差异(P>0.05)。将入选人群分为低龄孕妇组(<35岁)和高龄孕妇组(≥35岁),anti-HSVⅠ/ⅡIgM在低龄孕妇组的阳性检出率高于高龄孕妇组(χ2=31.934,P=0.000);anti-CMV IgM在高龄孕妇组的阳性检出率高于低龄孕妇组(χ2=7.888,P=0.005);anti-TOX IgM在高龄孕妇组的阳性检出率高于低龄孕妇组(χ2=8.929,P=0.003);anti-RV IgM的阳性检出率在两年龄组间无差异(χ2=3.012,P=0.083)。在调查人群中,IgG类抗体中巨细胞病毒抗体IgG(anti-CMV IgG)的阳性检出率最高,达84.36%(2 455/2 910)(P<0.05),弓形虫抗体IgG(anti-TOX IgG)阳性检出率最低,仅为1.22%(27/2 216)(P<0.05)。结论北京地区育龄期妇女anti-TORCH阳性检出率较高,孕期及孕前及时进行检测,以预防新生儿先天性TORCH感染是有必要的。

Objective To analyze anti-TORCH antibodies among women at childbearing age in Beijing in order to provide reference for the healthcare of women at childbearing age. Methods 6 978 women received preconception screening and pregnancy screening in Peking University Peopleˊs Hospital from November 2012 to November 2013 were given anti-TORCH test with CLIA. Results The highest seropositive rate was anti-HSVⅠ/ⅡIgM〔11. 19%（779/6 962）〕,which was significantly higher than the other three pathogens,and the difference was statistically significant（P all〈0. 007）. It was followed by anti-RV IgM and anti-CMV IgM,whose seropositive rate was 2. 63%（176/6 691）and 2. 54%（167/6 564）respectively,showing no statistically significant difference（P=0. 755）. Anti-TOX IgM had the lowest seropositive rate〔0. 62%（41/6 601）〕, showing statistically significant difference（ P 〈0. 007 ） . The results showed a higher prevalence of anti -HSVⅠ/Ⅱ IgM in spring and autumn〔12. 48%（280/2 244）and 12. 41%（195/1 571）,respectively〕,while the seropositive rate of anti-CMV IgM was significantly higher in autumn〔3. 66%（541/1 475）〕than other seasons（P〈0. 007）. The seropositive rate of anti-TOX IgM and anti-RV IgM in different seasons showed no statistically significant difference（ P . 0. 05 ） . All the cases were divided into young group（ 〈35 years）and old group（≥35 years）. The seropositive rate of anti-HSVⅠ/ⅡIgM in the young group was higher than in the old group（χ2 =31. 934,P=0. 000）,while the seropositive rate of anti-CMV IgM in the old group was higher than in the young group（χ2 =7. 888,P=0. 005）,and the seropositive rate of anti-TOX IgM in the old group was higher than in the young group（χ2 =8. 929,P=0. 003）. The seropositive rate of anti-RV IgM showed no statistically sig-nificant difference between the two groups（χ2 =3. 012,P=0. 083）. Among the women surveyed,the anti-CMV IgG had thehighest seropositive rate at 84. 36%（2 455/2 910）（P〈0. 05）,and the anti-TOX IgG had lowest seropositive rate at 1. 22%（27/2 216）（P〈0. 05）. Conclusion The seropositive rate of TORCH is fairly high among women at childbearing age in Bei-jing. It is necessary to adopt new approaches conduct preconception and pregnancy test to prevent congenital TORCH infection.