人类巨细胞病毒先天性感染的产前诊断

Prenatal Diagnosis of Congenital Infection with Human Cytomegalovirus

[目的]探讨人类巨细胞病毒（human cytomega-lovirus,HCMV)先天性感染的敏感指标。[方法]应用病毒分离培养，ELISA及PCR技术检测原发感染或继发活动性感染孕妇羊水中的HCMV，HCMV-IgM,HCMV-DNA以及羊水沉渣中的HCMV-DNA。[结果]93例羊水上清液标本分离培养出HCMV52例，HCMV-IgM11例，HCMV-DNA阳性78例，阳性率分别为55.8%。11.6%和83.9%。羊水沉渣HCMV-DNA阳性54例，阳性率58.1%。与羊水上清液HCMV分离培养检出率比较差异无显著性（X^2=1.78,P>0.05)。但显著高于羊水HCMV-IgM抗体的检测（X^2=9.27,P<0.05)。而羊水上清液的HCMV-DNA检测率均显著高于其他指标的检测（P<0.05)。[结论]羊水上清液HCMV-DNA的检测可为先天性HCMV感染的产前诊断提供重要的信息。

ObjectivesTo explore the sensitive prenatal diagnostic index of congenital infection with human cytomegalovirus (HCMV).MethodsThe detection of HCMV?HCMV IgM?HCMV DNA in thesupernatants of amniotic fluid and HCMV DNA in its deposit were carried out by virus isolation and cultivation, ELISA and PCR respectively in 93 pregnant women with primary or secondary active infection of HCMV.ResultsFifty two cases of HCMV(55.8%),11 cases of HCMV IgM(11.6%) and 78 cases of HCMV DNA(83.9%) were confirmed from 93 supernatant samples of amniotic fluid. Fifty four cases of HCMV DNA (58.1%) were detected in the deposit of amniotic fluid, there was no difference between this positive rate and isolation/detection rate of HCMV from supernatants(χ 2=1.78,P>0.05),but it was significantly higher than the positve detection rate of HCMV IgM antibody in amniotic fluid (χ 2=9.27,P<0.05).The positive rate of HCMV DNA detection in supernatants was significantly higher than all other HCMV indices (P<0.05).Conclusion HCMV DNA detection in supernatants of amniotic fluid is a sensitive prenatal diagnostic index for congenital infection with HCMV.