人巨细胞病毒感染对胎、婴儿发育影响的前瞻性研究  

A Prospective Study of the Effects on Fetal and Infant's Development after Human Cytomegalovirus Infection

作　　者：王志新[1] 闻良珍[1] 吕绳敏[1] 吴圣楣[1] 敖黎明[1] 刘兰青[1] 邢玮[1] 曾万江[1] 凌霞珍[1] 

机构地区：[1]武汉同济医科大学附属同济医院妇产科,沈阳中国医科大学附属第二医院病毒室,上海第二医科大学附属儿科医学研究所

出　　处：《同济医科大学学报》1996年第5期382-385,共4页Acta Universitatis Medicinae Tongji

基　　金：国家八五攻关课题

摘　　要：采用ＥＬＩＳＡ法检测２５７７例妊娠早期妇女血清中的人巨细胞病毒（ＨＣＭＶ）特异性抗体，对ＨＣＭＶ－ＩｇＭ阳性者应用聚合酶链反应（ＰＣＲ）检测胎儿附属物中的ＨＣＭＶＤＮＡ，将其中ＨＣＭＶＤＮＡ阳性的９９例视为感染组，阴性者９３例为对照组。采用不同的监测方法动态现在两组胎儿宫内及分娩时的状况，以及出生后２～３０个月婴幼儿的生长发育情况。结果显示：感染组死胎、畸形、宫内发育迟缓、新生儿窒息等的发生率均高于对照组（均为Ｐ＜０．０５），而新生儿平均身高、体重均低于对照组（均为Ｐ＜０．０５）；婴幼儿期感染组中头颅超声、脑干听觉诱发电位（ＢＡＥＰ）的异常率明显高于对照组（均为Ｐ＜０．０５），智力发育指数的平均值明显低于对照组（Ｐ＜０．０１）；说明先天性ＨＣＭＶ感染与出生缺陷，婴幼儿期神经系统、智力发育迟缓，听力障碍等有密切关系。Enzyme-linked immunoabsorbed assay(ELISA)was used to detect human cytomegalovirus (HCMV)specific antibodies in the serum of 2 577 women with 6￣12 week's gestational age, and HCMV DNA in villus,amniotic fluid,umbilical blood,neonatal blood and neonatal urine were screened by polymerase chain reaction(PCR).Regarding those who had at least one sample HCMV DNA positive as study group and HCMV DNA negative as control group,we used different monitoring methods to observe successively the status of fetus in the uterus and after dilivery and of infant's development.The prospective study showed that in the study group the occurrences of fetal death,congenital malformation,IUGR,and neonatal suffocation were significantly higher than those of the control group(P<0.05), and their neonatal mean weight and height were significantly lower than those of the latter (P<0.05).This study also showed that in the study group, the occurrences of abnormal phenomena of brain ultrasonic flow detector,brain acoustic entice potential(BAEP)were notably higher than those of the control group(P<0.05),and the infant's mental development was remarkably slower than that of the latter(P< 0.01).It is concluded that congenital HCMV infection is closely correlated with fetal defect,infant's central nervous system and mental development retardation.

关 键 词：人 巨细胞病毒 感染 诱发电位 听觉 婴幼儿 胎儿 

分 类 号：R715[医药卫生—妇产科学] R373.9[医药卫生—临床医学]