超声联合试验室检查对宫内胎儿TORCH感染的诊断价值研究  

Value of ultrasound combined with laboratory examination in diagnosis of intrauterine fetal TORCH infections

作　　者：张丽 张庆欣[2] 芦莉 董玉花 马春花 马金莲 杨桂清 陈建华 瓦迎芳 

机构地区：[1]青海省妇幼保健院超声科,青海西宁800001 [2]青海省人民医院超声科,青海西宁800001

出　　处：《中华医院感染学杂志》2017年第21期4986-4988,共3页Chinese Journal of Nosocomiology

基　　金：青海省自然科学基金资助项目(QH2818222)

摘　　要：目的探讨超声联合试验室检查对胎儿宫内TORCH感染的诊断价值。方法回顾性分析2013年5月-2016年8月在医院接受孕检的孕妇临床资料,所有孕妇均采用酶联免疫吸附法对其血清TORCH特异性抗体进行检测,同时接受超声检查观察胎儿发育情况,观察试验室检查诊断胎儿宫内TORCH感染的准确性,分析超声对宫内感染胎儿发育的预测价值。结果 110名胎儿中,确诊发生宫内TORCH感染者18例,感染率为16.36%;110名孕妇中,血清抗TORCH IgM抗体阳性20例,阳性率18.18%;感染孕妇血清IL-6、IL-8、TNF-α、CRP和IgM水平均高于未感染孕妇(P<0.001);血清IL-6、IL-8、TNF-α、CRP和IgM水平对胎儿宫内TORCH感染诊断的灵敏度为82.5%、84.9%、75.3%、68.7%、80.2%特异度为80.3%、78.5%、70.1%、73.2%、78.8%,诊断指数159.3%、165.2%、142.6%、135.2%、160.5%;通过超声对确诊为宫内TORCH感染胎儿进行诊断,发现发生胎儿发育异常者4例,其中包括脐膨出1例,单脐动脉肾盂积水1例,发育迟缓2例,与胎儿出生后诊断结果一致。结论 IL-6、IL-8、TNF-α、CRP和IgM水平对胎儿宫内TORCH感染有较好的诊断价值,且结合超声影像学结果可预测胎儿的发育情况,具有良好的临床应用价值。OBJECTIVE To explore the value of ultrasound combined with laboratory examination in diagnosis of intrauterine fetal TORCH infectioins.METHODS The clinical data of the pregnant women who received pre-pregnancy checks in hospitals from May 2013 to Aug 2016 were retrospectively analyzed.The serum TORCH specific antibodies of the pregnant women were detected by using enzyme-linked immunosorbent assay,meanwhile,the fetal development was observed through ultrasound examination,the accuracy of laboratory examination in diagnosis of the intrauterine fetal TORCH infections was observed,and the value of ultrasound in prediction of development of fetuses with infections was analyzed.RESULTS Of 110 fetuses,18 were diagnosed with intrauterine TORCH infections,with the infection rate 16.36%.Among the 110 pregnant women,20 were positive for the serum TORCH IgM antibody,with the positive rate 18.18%.The levels of serum IL-6,IL-8,TNF-α,CRP and IgM of the pregnant women with infection were higher than those of the pregnant women without infection（P〈0.001）.The sensitivities of the serum IL-6,IL-8,TNF-α,CRP and IgM were respectively 82.5%,84.9%,75.3%,68.7% and80.2%in diagnosis of the intrauterine fetal TORCH infections;the specificities were respectively 80.3%,78.5%,70.1%,73.2% and 78.8%;the diagnosis indexes were respectively 159.3%,165.2%,142.6%,135.2%and 160.5%.The ultrasound examination results showed that among the fetuses diagnosed with intrauterine TORCH infections,4 were fetal abnormalities,including 1 case of omphalocele,1 case of single umbilical artery hydronephrosis and 2 cases of growth retardation,which were consistent with the diagnosis results after the birth of the fetuses.CONCLUSIONThe IL-6,IL-8,TNF-α,CRP and IgM have high value in diagnosis of the intrauterine fetal TORCH infection,and its combination with the ultrasound imaging can predict the fetal development,which has high clinical application value.

关 键 词：超声 宫内感染 TORCH 发育 

分 类 号：R714.62[医药卫生—妇产科学]