人巨细胞病毒感染与先天性畸形关系的探讨  

Human Cytomegalovirus Infection and Congenital Malformation

作　　者：卢彦平[1] 翁霞云[1] 谷志远[1] 宋海静[1] 赵海潞[1] 刘爽[1] 曾木英[1] 

机构地区：[1]解放军总医院

出　　处：《中华妇产科杂志》1998年第3期132-135,I004,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨人巨细胞病毒（ＨＣＭＶ）宫内感染与先天性畸形的关系，并确定巨细胞病毒感染的组织细胞类型。方法利用聚合酶链反应（ＰＣＲ）技术，对近８年来我院尸检畸形儿４１例（畸形组）及同期尸检非畸形儿１９例（对照组）进行了主要脏器的ＨＣＭＶ检测，对部分ＰＣＲ阳性的组织标本，用原位杂交技术（ＩＳＨ）确定ＨＣＭＶ易感组织细胞类型。结果畸形组ＨＣＭＶ阳性率为４６．３４％（１９／４１），对照组阳性率为５．２６％（１／１９），两者相比差异有显著性；畸形组中ＨＣＭＶ脏器阳性率为２０．４６％（３５／１７１），而对照组仅有１份肺组织呈ＨＣＭＶ阳性，阳性率为１．２８％（１／７８），两者相比差异有极显著性；ＨＣＭＶ感染在消化系统畸形中更多见，但各系统畸形阳性率差异无显著性；畸形儿脑组织中ＨＣＭＶ阳性率最高（４１．３８％，１２／２９），与其他组织相比，差异有显著性；ＰＣＲ阳性的１７份标本中仅６份ＩＳＨ阳性，位于脑组织的神经元细胞、神经胶质细胞、肾小管上皮细胞及部分间质细胞、肺上皮细胞等。结论ＨＣＭＶ宫内感染与先天性畸形密切相关；脑是ＨＣＭＶ最易侵犯的器官；ＰＣＲ与ＩＳＨ结合用于ＨＣＭＶ的诊断，既敏感。Objective To study the relationship between intrauterine cytomegalovirus (HCMV) infection and congenital malformation, and to determine the distribution of tissues infected. Methods Autopsy samples of 41 infants with congenital malformation and 19 infants with normal appearances were studied. Using polymerase chain reaction (PCR) technique the paraffin embedded specimens of main organs were examined for HCMV infection. In situ hybridization (ISH) was performed in some of the PCR positive tissues in order to define the distribution of HCMV DNA. Results 19 of the 41 infants (46.34%) with congenital defects were HCMV positive, while 1 in 19 (5.26%) were positive in the control group, and there was significant difference between the 2 groups ( P <0.05). 20.46% (35/171) of the fetal organ samples were HCMV DNA positive in the malformation group, but only 1 out of 78 samples (1.28%) was positive in the pulmonary tissue of the control group. More malformations of the digestive system were presented in HCMV infected babies but no statistical significant difference when compared with other systems. Brain tissue had the highest HCMV infection rates (41.37%, 12/29), which was significantly higher than other organs. By ISH technique HCMV DNA was found only in 6 out of 17 PCR positive samples, and they were located at neurons, neurogliocytes, epithelium and interstitial cells of the kidney, and epithelial cells of pulmonary alveolar. Conclusion There are strong correlation between HCMV infection and congenital malformation, and brain is more susceptible to HCMV. By combining PCR and ISH, both sensitivity and distribution of HCMV could be obtained.

关 键 词：巨细胞病毒 畸形 先天性畸形 宫内感染 PCR 

分 类 号：R714.251[医药卫生—妇产科学] R714.53[医药卫生—临床医学]