摘要
目的 探讨逆转录聚合酶链反应 (RT PCR)技术用于产前诊断人巨细胞病毒 (HCMV)宫内活动性感染的临床价值。方法 应用酶联免疫吸附试验 (ELISA)、RT PCR及血浆套式聚合酶链反应 (N PCR)法 ,检测 2 0 9例孕妇外周血HCMVmRNA、HCMVIgM及HCMVDNA ,其中任意 2项阳性为HCMV活动性感染 (99例 ,观察组 )、任意 2项均阴性为非活动性感染 (110例 ,对照组 )。应用RT PCR和N PCR技术 ,检测两组孕妇从宫内采集的孕早期绒毛共 78例、孕中期脐血和羊水共 131例 ,并追踪胎儿生长发育及出生后情况。结果 (1)观察组绒毛、脐血HCMV感染率分别为 5 3 3% (16 30 )、4 7 8% (33 6 9) ;对照组分别为 8 3% (4 4 8)、9 7% (6 6 2 ) ,两组比较 ,差异有极显著性 (P <0 0 0 1)。观察组绒毛、脐血HCMV活动性感染率分别为 30 0 % (9 30 )和 2 9 0 % (2 0 6 9) ;显著高于对照组的 4 2 %(2 4 8)和 4 8% (3 6 2 ) ,两组比较 ,差异有极显著性 (P <0 0 0 1)。 (2 )HCMVDNA阳性胎儿中 ,HCMVmRNA阳性胎儿的流 (早 )产率为 4 1 2 % (14 34) ,显著高于HCMVmRNA阴性胎儿的 8 0 % (2 2 5 )。HCMV活动性感染胎儿中 ,有 10例因胎儿生长发育异常而行终止妊娠术。结论 应用RT PCR技术产前诊断HCMV宫内活动性感染安全可靠 。
Objective To study the clinical value of antenatal diagnosis of intrauterine active human cytomegalovirus (HCMV) infection with reverse transcription polymerase chain reaction(RT-PCR). Methods The active HCMV infection of pregnant women was diagnosed with enzyme-linked immunosorbent assay (ELISA), serum Nest-PCR (N-PCR) and RT-PCR. The methods of antenatal diagnosis include villus sampling, amniocentesis and cordocentesis under ultrasound guidance. RT-PCR and N-PCR was used to screen fetal active infection. Results The infection rate of chorionic villi and cord blood whose mother was in active infection is 53.3%(16/30) and 47.8%(33/69)respectively, whereas that whose mother just had infectious history is 8.3%(4/48), 9.7%(6/62) respectively,the differences are statistically significant respectively ( P <0.001). The active infection rate of chorionic villi and cord blood in maternal active infection group is 30.0%(9/30)and 29.0%(20/69) respectively, whereas that with infectious history is 4.2%(2/48)and 4.8%(3/62),the differences are statistically significant respectively ( P <0.001). In the active intrauterine infection, the incidence of abortion and premature delivery was 41.2%(14/34), significantly higher than that of the latent infection 8.0%(2/25, P <0.01). Conclusions Antenatal diagnosis of intrauterine active HCMV infection with RT-PCR and the means of sampling described are of safety and reliability. It has a great clinical value in management of the fetus whose mother had been in active HCMV infection.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2002年第10期580-583,共4页
Chinese Journal of Obstetrics and Gynecology
基金
国家"九五"科技攻关计划资助项目 (96 90 4 0 6 0 8)
