产前诊断先天性人巨细胞病毒感染安全性和可靠性分析  

The Analysis of the security and reliability of the prenatal diagnosis for the congenital human cytomegalovirus infection

作　　者：邓东锐[1] 闻良珍[1] 陈素华[1] 熬黎明[2] 刘兰清[3] 凌霞珍华 

机构地区：[1]中科技大学同济医学院附属同济医院妇产科,430030 [2]上海第二医科大学儿科研究所 [3]中国医科大学第二临床学院病毒研究室

出　　处：《中国妇幼保健》2005年第15期1860-1862,共3页Maternal and Child Health Care of China

基　　金：国家"九五"科技公关课题(项目编号:96-904-06-08)

摘　　要：目的:探究宫内取材进行先天性人巨细胞病毒(HCMV)感染产前诊断的安全性和可靠性。方法:联合应用酶联免疫吸附试验(ELISA)、巢式PCR(N-PCR)和逆转录PCR(RT-PCR)分析武汉、上海和沈阳三地6723例育龄妇女和孕妇HCMV感染状况及妊娠结局。结果:育龄妇女活动性HCMVIgM检出率为6·11%,其中孕妇和非孕妇间无显著性差异。活动性感染孕妇绒毛、脐血HCMV感染率分别为51·52%、66·18%,明显高于对照组。先天性感染儿发生异常妊娠结局的危险性明显高于非感染儿。宫内取材所致妊娠丢失率均无显著增加,其检查结果与出生后的诊断一致。结论:宫内采集绒毛、羊水、脐血进行产前诊断,安全性和可靠性良好,可为胎儿的取舍提供依据。Objective： To explore the security and reliability of the prenatal diagnosis by intrauterine sampling for the congenital HCMV infection, Methods, Enzyme - linked immunosorbent assay （ELISA） combined with nested - polymerase china reaction （ N - PCR）and reverse transcription -PCR （RT- PCR） technique were used to analyse the state of active HCMV infection and the pregnancy outcome in 6 723 cases of child - bearing - aged and pregnant women in Wuhan, Shanghai and Shenyang. Results： The positive rate of HCMV IgM antibody was 6. 11% and there was no difference between pregnant women and non -pregnant women. The infective rate in ehorionic villus and cord blood of the pregnant women with active infection was 51.52% and 66. 18% respectively, Both of them were significantly higher than that of the control group. The incidence of the abnormal pregnant outcome augmented prominently in the congenital infective fetus. The pregnant missing rate in the prenatal diagnostic group did not increase. The pre - and postnatal diagnostic results were identical. Conclusion ：The prenatal diagnosis by chorionic villus, amniotic fluid and/or cord blood is safe and reliable, and can provide some evidences for the decision of the acceptance or rejection of the fetus with congenital infection.

关 键 词：人巨细胞病毒 感染 产前诊断 绒毛吸取术 羊膜腔穿刺术 脐血穿刺术 

分 类 号：R714[医药卫生—妇产科学]