孕前及妊娠期TORCH血清学IgM阳性的实验室对策  

Laboratory measures after TORCH serological IgM positive before and during pregnancy

作　　者：朱宇宁[1] 张龙 Zhu Yuning;Zhang Long(Department of Clinical Laboratory,Women's Hospital,Zhejiang University,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属妇产科医院检验科,杭州310006

出　　处：《中华检验医学杂志》2020年第5期520-524,共5页Chinese Journal of Laboratory Medicine

基　　金：国家重点研发计划课题(2018YFC1002702)。

摘　　要：TORCH是指一系列可能导致流产、早产、畸胎、死胎、宫内发育迟缓、新生儿多脏器损害等不良妊娠结局的病原体,以弓形虫、风疹病毒、巨细胞病毒、单纯疱疹病毒、人细小病毒B19等为主要代表。血清学检测病原特异性免疫球蛋白M(IgM)抗体、免疫球蛋白G(IgG)抗体是目前的主要筛查手段,IgM抗体阳性通常提示患者可能处于急性感染期,是临床非常关注的问题。IgM抗体阳性并不等同于急性感染期,需要结合免疫学检测方法特点、病原体感染后的机体免疫反应规律、临床表现等进行综合评估,否则可能会给临床处置造成困扰。规范性的TORCH血清学筛查及系统性实验室检测可协助孕前指导以及孕期胎儿风险评估,有助于防范妊娠风险、降低出生缺陷。TORCH,represented by the Toxoplasmosis,Rubella virus,Cytomegalovirus,Herpes simplex virus or Human Parvovirus B19,is considered as a series of pathogens which might lead to the miscarriage,premature birth,teratogenesis,stillbirth,intrauterine growth retardation or multiple-organic damage in newborns.Serological examination of the pathogen-specific antibodies,including IgM and IgG,is currently the foremost laboratorial strategy for clinical laboratory of TORCH.Although the serum-IgM level often indicates the acute infection period of patients and is of the great clinical concern,the combination of different strategies,such as immunological methods or clinical manifestations is valuable to ensure the accuracy and specificity.Normative TORCH serological screening and systematic laboratory testing can assist pre-pregnancy guidance and fetal risk assessment during pregnancy,help to prevent the pregnancy risks and reduce the birth defects.

关 键 词：巨细胞病毒感染 单纯疱疹 风疹 弓形虫病 血清学试验 

分 类 号：R714.251[医药卫生—妇产科学]