山东地区不孕不育人群TORCH感染情况分析

Analysis of TORCH infection in infertility patients in Shandong

目的统计分析2014年1月~2016年12月在山东大学附属生殖医院(山大生殖)就诊的91 331例不孕不育患者的TORCH病原体感染检测结果,探讨该人群TORCH感染情况,以分析TORCH感染对不孕不育的影响,为优生优育提供支持。方法回顾性分析。2014年1月~2016年12月在山大生殖就诊的91 331例患者TORCH资料,利用化学发光免疫分析法进行的TORCH免疫球蛋白抗体IgM和IgG的检测结果,进行数据统计。结果 91 331例不孕患者血清TORCH CMV-IgM、HSV-IgM、RVIgM、TOXO-IgM的阳性率分别为0.39%、11.83%、0.82%、0.25%;CMV-IgG、HSV-IgG、RV-IgG、TOXO-IgG的阳性率分别为97.00%、95.98%、82.46%、0.86%。TOXO感染的阳性率最低。TORCH急性感染CMV、HSV阳性率存在性别差异,而在既往感染CMV、HSV、RV均表现出了性别差异性,且均以女性的感染率较高。该地区TORCH病原体CMV、HSV、RV的感染模式均以IgM-/IgG+为主,而TOXO则主要表现为IgM-/IgG-模式。男性和女性患者急性感染的HSV的阳性率存在显著的年龄差异,而CMV、RV、TOXO各年龄段间差异无统计学意义,但整体呈现阳性率随年龄增大而降低的趋势。不孕不育群体男性TORCH四种病原体感染阳性率季节差异没有统计学意义,而女性CMV的感染阳性率存在季节差异以冬春季的感染阳性率较高,其他三种病原体感染阳性率亦无明显季节差异。结论山东地区不孕不育患者急性感染以HSV-IgM为主,既往感染则以CMV-IgG、HSV-IgG为主,TOXO感染的阳性率最低。TORCH的某些病原体感染存在性别、年龄、季节感染差异。

Objective：Statistic analyzing 91 331 TORCH infection tests of infertility patients from January 2014 to December 2016 in reproductive hospital affiliated to Shandong university（SDUIVF in short）,exploring their TORCH infection situation,to analyze the impact of TORCH infection to infertility and provide support for eugenics. Methods：Retrospective analyze. Statistic analyze 91 331 TORCH infection tests of both IgM and IgG using chemiluminescence immunoassay from January 2014 to December 2016 in SDUIVF. Results：For 91 331 TORCH infection tests of CMV-IgM and HSV-IgM,RV-IgM,TOXO-IgM,their positive rate was 0.39%,11.83%,0.82%,0.25% respectively. Similarly the positive rate of CMV-IgG,HSV-IgG,RV-IgG,TOXO-IgG was 97.00%,95.98%,82.46%,0.86% respectively. Positive rate of TOXO was lowest. For TORCH acute infection,significant difference was found in sexes of CMV and HSV,While CMV,HSV and RV of previous infection,all had significant difference in sexes. Female had the higher infection rate. CMV and HSV,RV infection model were given priority to IgM-/IgG＋,while TOXO was mainly for IgM-/IgG-. With the exception of HSV,no significant difference was found among different ages of CMV and RV,TOXO,but decreased positive rate was found among older group. Although four TORCH pathogens all had no significant season difference in male infertility,CMV positive rate had significant season difference in female infertility. Conclusion：Infertility patients′ acute infection in Shandong was given priority to with HSV-IgM,and previous infection was given priority to CMV-IgG and HSV-IgG. TOXO infection positive rate was the lowest. Some of the TORCH pathogens had significant difference in sex and age,season.