RT-PCR技术在产前诊断HCMV宫内活动性感染的研究  

Diagnosis of intrauterine active human cytomegalovirus infection with reverse transcription polymerase chain reaction

作　　者：傅文婷[1,2] 张畅斌[1,2] 胡晶晶[1,2] 尹爱华[1,2] 

机构地区：[1]广东省妇幼保健院 [2]广东省妇女儿童医院产前诊断中心,广州510010

出　　处：《中国优生与遗传杂志》2013年第9期23-25,共3页Chinese Journal of Birth Health & Heredity

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311例孕妇外周血HCMV mRNA、HCMV IgM及HCMV DNA,其中任意2项阳性为HCMV活动性感染(119例,观察组)、任意2项均阴性为非活动性感染(192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108例、孕中期脐血和羊水共203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55%(22/40)、48.1%(38/79);对照组分别为10.3%(7/68)、11.3%(14/124),两组比较,差异有极显著性(P<0.001)。观察组绒毛、脐血HCMV活动性感染率分别为32.5%(13/40)和30.4%(24/79);显著高于对照组的5.8%(4/68)和6.45%(8/124),两组比较,差异有极显著性(P<0.001)。(2)HCMV DNA阳性胎儿中,HCMVmRNA阳性胎儿的流(早)产率为42.9%(21/49),显著高于HCMV mRNA阴性胎儿的12.5%(4/32)。HCMV活动性感染胎儿中,有12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,对于活动性感染孕妇的胎儿取舍具有临床指导价值。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 eordocentesis 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 55% （22/40） and 48.1% （38/79） respectively, whereas that whose mother just had infectious history is 10. 3% （7/68）, 11.3% （14/124） 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 32. 5% （13 /40） and 30. 4% （24 / 79） respectively, whereas that with infectious history is 5. 8% （4/68） and 6. 45% （ 8/124）, the differences are statistieally significant respectively （ P 〈 0. 001 ）. In the active intrauterine infection, the incidence of abortion and premature delivery was 42. 9% （21/49 ）, significantly higher than that of the latent infectionl2. 5% （4/32, 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.

关 键 词：巨细胞病毒感染 垂直传播 产前诊断 

分 类 号：R714.55[医药卫生—妇产科学]