芜湖地区育龄妇女TORCH感染的血清学调查分析

Serological investigation and analysis of TORCH infection in women of childbearing age in Wuhu Area

目的了解芜湖地区育龄妇女TORCH(T:弓形虫,O:其他病原体,R:风疹病毒,C:巨细胞病毒,H:单纯疱疹病毒)感染情况和流行特点,为本地区优生优育工作提供依据。方法选取2016年4月-2020年8月某医院18~45岁的育龄妇女1443例作为研究对象,应用电化学发光法检测育龄妇女血清中的TORCH特异性抗体,统计分析血清弓形虫(Toxoplasma gondii,TOX)-免疫球蛋白M(immunoglobulin M,IgM)、TOX-免疫球蛋白G(immunoglobulin G,IgG)、风疹病毒(Rubella virus,RV)-IgM、RV-IgG、巨细胞病毒(Cytomegalo virus,CMV)-IgM、CMV-IgG、单纯疱疹病毒(Herpes simplex virus,HSV)-Ⅰ-IgG及HSV-Ⅱ-IgG阳性率。结果TORCH-IgM阳性率分别为TOX 0.14%、RV 0.83%、CMV 2.49%;TORCH-IgG阳性率分别为TOX 5.96%、RV 68.47%、CMV 81.70%、HSV-Ⅰ 73.04%、HSV-Ⅱ 11.99%。结果显示,低龄和中龄育龄妇女组均以CMV-IgM(2.18%、2.53%)和CMV-IgG(81.92%、82.30%)阳性率最高,高龄育龄妇女组以CMV-IgM(5.56%)和HSV-Ⅰ-IgG(81.11%)阳性率最高;RV-IgM秋季感染率最高(3.48%),CMV-IgM春季感染率最高(6.86%),HSV-Ⅱ-IgG夏季感染率最高(18.54%),TOX-IgM和TOX-IgG不同季节感染率比较,差异无统计学意义(χ^(2)=2.21、5.87,P>0.05)。除单一病毒感染外,育龄妇女还存在混合感染,主要以RV和CMV混合感染为主。结论芜湖地区育龄妇女TORCH急性感染中以CMV-IgM为主,既往感染中以CMV-IgG、HSV-Ⅰ-IgG为主,临床上应加强育龄妇女孕前及孕期的TORCH筛查。

Objective To understand the infection situation and epidemic characteristics of TORCH(T:Toxoplasma gondii,O:other pathogens, R:Rubella virus, C:Cytomegalo virus, H:Herpes simplex virus) in women of childbearing age in Wuhu Area, and to provide a basis for eugenic work in this area.Methods A total of 1 443 women of childbearing age between 18 and 45 years old in a hospital were chosen as the research object during April 2016 to August 2020.The electrochemiluminescence method was applied to detect TORCH-specific antibodies in the serum of women of childbearing age, and the antibody positivity rate of serum was statistically analyzed for Toxoplasma gondii(TOX)-immunoglobulin M(IgM),TOX-immunoglobulin G(IgG),Rubella virus(RV)-IgM, RV-IgG,Cytomegalo virus(CMV)-IgM,CMV-IgG,Herpes simplex virus(HSV)-Ⅰ-IgM and HSV-Ⅱ-IgG.Results The positive rates of TORCH-IgM were 0.14% for TOX,0.83% for RV,and 2.49% for CMV,respectively.The positive rates of TORCH-IgG were 5.96% for TOX,68.47% for RV, 81.70% for CMV,73.04% for HSV-Ⅰ,and 11.99% for HSV-Ⅱ.The results showed that the positive rates of CMV-IgM(2.18%,2.53%) and CMV-IgG(81.92%,82.30%) were the highest among women of childbearing age in both the young and middle age groups, while the positive rates of CMV-IgM(5.56%) and HSV-Ⅰ-IgG(81.11%) were the highest among women of childbearing age in the older age group.RV-IgM had the highest infection rate in the fall(3.48%),CMV-IgG had the highest infection rate in the spring(6.86%),and HSV-Ⅱ-IgG had the highest infection rate in the summer(18.54%).Comparison of the infection rates of TOX-IgM and TOX-IgG in different seasons showed no statistically significant difference(χ^(2)=2.21,5.87,P>0.05).In addition to single virus infection, there were mixed infections in women of childbearing age, mainly mixed RV and CMV infections.Conclusion CMV-IgM predominates in acute TORCH infections and CMV-IgG and HSV-Ⅰ-IgG predominated in previous infections among women of childbearing age in the Wuhu Area.TORCH screening should be strengthened for women of childbearing age before and during pregnancy in clinical practice.