人巨细胞病毒在华中地区孕妇和住院儿童群体中的流行病学调查  

The epidemiology of human cytomegalovirus among pregnant women and children in central China area

作　　者：王婷[1] 段歌红[1] 陈茂才[1] 冀恒涛[1] 崔会玲[1] 

机构地区：[1]郑州大学第二附属医院检验科,郑州450014

出　　处：《微生物与感染》2015年第5期288-293,共6页Journal of Microbes and Infections

基　　金：河南省医学科技攻关计划项目(201403085)

摘　　要：对华中地区孕妇和住院儿童进行人巨细胞病毒(HCMV)感染流行病学调查,并分析乳汁、尿液和外周血单个核细胞(PBMC)中HCMV DNA载量对临床的诊断价值。应用电化学发光法检测HCMV特异性IgM和IgG抗体;采用实时荧光定量聚合酶链反应(PCR)检测母亲乳汁、尿液和PBMC中HCMV DNA水平。孕妇和儿童的IgM阳性率分别为1.16%和8.13%(新生儿2.06%,早产儿3.50%),而IgG阳性率分别为96.59%和79.98%(新生儿83.84%,早产儿94.59%)。住院儿童尿液的HCMV DNA阳性率为57.25%,而PBMC的HCMV DNA阳性率仅为7.97%(P<0.001)。母亲乳汁的HCMV DNA阳性率为44.61%,而PBMC的HCMV DNA阳性率仅为0.77%(P<0.001)。结果表明,孕妇HCMV感染率很高,同时HCMV是住院儿童感染的重要病原体,且早产儿比足月儿对HCMV更具易感性。在住院儿童中,尿液标本用于检测HCMV DNA比PBMC标本具有更高的灵敏度。而哺乳母亲乳汁的HCMV DNA阳性率显著高于PBMC,表明HCMV在乳汁中载量较高,因此哺乳是HCMV的重要母婴传播途径。This study aims to investigate the epidemiology of human cytomegalovirus （HCMV） among pregnant women and hospitalized children in central China area, and to evaluate the value of different samples [breast milk, urine and peripheral blood mononuclear cells （PBMCs） for diagnosis of HCMV infection. HCMV-specific IgM and IgG antibodies were determined by electrochemiluminescence immunoassay to verify the infection status of HCMV. DNA isolated from different samples was subjected for the detection of HCMV-specific gene（s） by real-time fluorescence quantitative polymerase chain reaction （PCR）. For pregnant women and hospitalized children, the positive rate of lgM was 1.16% and 8.13% respectively. The rates for newborns and preterm infants were 2.06% and 3.50%. The positive rates of IgG for HCMV among pregnant women and hospitalized children were 96.59% and 79.98%, respectively, while the rates among newborns and preterm infants were 83.84% and 94.59%, respectively. The positive rates of HCMV DNA detection were 57.25% and 7.97% for urine and PBMCs, respectively （P〈0. 001）. 44.61% of mothers shed HCMV DNA in breast milk, while 0.77% were found positive in PBMCs （P〈 0. 001）. The results suggest that HCMV infection rate in pregnant women is considerably high and HCMV is one of the pathogens for hospitalized children infection. The preterm infants seem more sensitive to HCMV infection than the term infants, and the analysis of the presence of viral DNA from urine in hospitalized children is more suitable for the diagnosis of HCMV infection. HCMV DNA has a higher positive rate in breast milk than in PBMCs from lactating mothers and maternal milk is the main source for HCMV transmission from mother to infant.

关 键 词：人巨细胞病毒 病毒DNA 乳汁 尿液 血清阳性率 

分 类 号：R714.251[医药卫生—妇产科学] R725.1[医药卫生—临床医学] R440