先天性TORCH感染的诊断及临床分析  

Diagnosis and clinical analysis of congenital TORCH infection in newborn

作　　者：包蕾[1] 余加林[1] 

机构地区：[1]重庆医科大学附属儿童医院,400014

出　　处：《世界今日医学杂志》2005年第4期219-221,共3页World JOurnal of Medicine Today

摘　　要：目的分析先天性TORCH感染的临床诊断和表现，以提高认识，避免误诊误治。方法采用ELISA法检测血清中的弓形体（TOX）、风疹病毒（RV）、单纯疱疹病毒（HSV）特异性鲫，巨细胞病毒（CMV）IgG的滴度变化；采用抗体检测捕获法检测CMV IgM；梅毒采用特异血清试验TRUST、TPPA。共确诊先天性TORCH感染的病儿66例。结果梅毒患儿临床表现典型，以早产54％（13／24）、窒息58％（14／24）、有神经系统异常体征45％（11／24）、各种皮肤损害50％（12/24）、骨损害50％（11/24）、肝脏肿大45％（11／24）多见。其他42例TORCH感染患儿早期表现不典型，其中病理性黄疸多见，占76％（32/42）；其余较少的表现有早产16％（7／42），小于胎龄儿12％（5，42），窒息11％（5／42），神经系统异常体征19％（8／42），肝脏肿大2％（1／42），直接胆红素增高5％（2/42）。RV感染以母孕期有感染史53％（7／13）和先心30％（4/13）较多见。结论先天性TORCH感染以病理性黄疽表现为主，除梅毒有典型的先天性官内感染的表现外，其他TORCH感染临床表现隐匿，容易漏诊，且少数可引起严重脑损伤。Aim To study clinical manifestation of TORCH infections as evidences for prevention and treatment of TORCH infections in pregnant women and newborn as early as possible. Methods ELASA was performed to screen specific anti- TORCH（Toxoplasmagondii, Cytomegalicbirus, Rubella virus, Herpes simplex virus ） IgM or IgG antibodies. Specific serological tests such as TRUST and TPPA for Syphilis were performed. Results Among newborns of congenital Syphilis, premature newborn came up to 54%, perinatal asphyxia 58%, abnormal manifestation of neurological system 45 % and rush 50%, hepatomegaly 45%. Among the rest newborn of TORCH infections, 76% cases had hyperbilimbinemia, premature newborn 16%, perinatal asphyxia 11%, abnormal manifestation of neurological system 19% and hepatomegaly 2%, 33% rubella virus infections cases had congenital heart disease. Conclusion Hyperbilirubinemia can be found in the majority of TORCH infections cases. Congenital Syphilis is manifest by obviously clinical symptoms and signs. Except Syphilis, without specific clinical manifestation was reported in the TORCH infections cases, but severe brain injury may be caused.

关 键 词：TORCH感染 诊断 新生儿 先天性TORCH感染 临床诊断 临床分析 ELISA法检测 病理性黄疸 单纯疱疹病毒 血清试验 

分 类 号：R725.1[医药卫生—儿科] R720.597[医药卫生—临床医学]