孕妇感染HCMV时IgG抗体亲和力与HCMV DNA联合检测的临床意义

【摘要】 目的:本文通过研究HCMV-IgG亲和力指数(avidity index,AI)以及HCMV-DNA的检测,对孕产妇原发性感染及继发性感染进行综合评价。旨在为防止和减少围产期感染、流产及新生儿先天畸形、听力障碍和智力障碍提供有效而准确的检测数据及临床诊断依据。方法:采用德国Virion/serion公司酶联免疫吸附试验(ELISA)定量试剂,检测孕妇血清中HCMV的IgM和IgG抗体、IgG抗体亲和力;采用中山医科大学达安公司RV核酸扩增(PCR)荧光定量检测孕妇血清中HCMV-DNA,并对其结果进行分析。结果:341例孕妇中,HCMV-IgG低亲和力样本孕产史不良孕妇组所占比例显著高于初次妊娠孕妇。孕产史不良孕妇HCMV-DNA阳性例数所占比例显著高于初次妊娠孕妇。结论:341例孕妇中存在一定比例的HCMV现症感染,建议妊娠妇女尤其是有不良孕产史者尽可能同时进行HCMV-IgG亲和力指数及HCMV-DNA检查,以便尽早采取措施,避免由于HCMV感染导致的新生儿出生缺陷的发生。

【关键词】 孕妇; 巨细胞病毒; 亲和力指数; HCMV DNA

The Clinical Significance of IgG Avidity in Pregnant Women Infected with HCMV and HCMV DNA Detection/DONG Yu-lin.//Medical Innovation of China,2012,9(28):008-010

【Abstract】 Objective:This article through the study of HCMV-IgG avidity index (avidity the index, AI) and HCMV-DNA detection, maternal primary infection and secondary infection of a comprehensive evaluation. Designed to prevent and reduce perinatal infections, abortion and neonatal congenital malformations, hearing impairment and mental retardation to provide effective and accurate test data and clinical diagnosis is based on.Method:Using the German Virion / serion enzyme-linked immunosorbent assay (ELISA) quantitative reagent, detected in maternal serum of HCMV IgM and IgG antibodies and IgG avidity; Zhongshan Medical University, Tat RV nucleic acid amplification (PCR) fluorescence quantitative detection maternal serum levels in HCMV-DNA, and the results were analyzed.Result:341 cases of pregnant women,maternal history of poor pregnant women group of HCMV-IgG low affinity sample proportion was significantly higher than the initial pregnancy. The adverse pregnancy history of pregnant women HCMV-DNA positive proportion of the number of cases was significantly higher than the initial pregnancy.Conclusion:341 cases of pregnant women in a certain proportion of HCMV now disease infection,it is recommended that pregnant women especially those with history of adverse pregnancy by as much as possible HCMV-IgG avidity index and HCMV-DNA checks in order to take early measures to avoid due to HCMV infection causes the occurrence of birth defects.

【Key words】 Pregnant women; Human cytomegalovirus; Avidity index; HCMV DNA

First-author’s address:Yan’an Hospital of Kunming,Kunming 650051,China

doi:10.3969/j.issn.1674-4985.2012.28.004

巨细胞病毒(cytomegalovirus,CMV)为疱疹病毒科β属的线性双链DNA病毒,感染人类的巨细胞病毒简称HCMV(human cytomegalovirus)。巨细胞包涵体病是巨细胞病毒通过胎盘传播的,孕妇感染巨细胞病毒是导致围产期感染、流产、死胎、早产、先天畸形、听力障碍及智力障碍的主要原因之一。本文通过研究341例孕妇的HCMV-IgG亲和力指数(avidity index,AI)以及HCMV-DNA的检测,对孕产妇原发性感染及继发性感染进行综合评价。