产前TORCH血清筛查阳性与不良妊娠结局  

TORCH serological screening in pregnant women and its relationship with adverse pregnancy outcomes

作　　者：金宇 崔莹 JIN Yu;CUI Ying(The Second Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, Sichuan Province, 610051)

机构地区：[1]成都医学院第二附属医院,核工业四一六医院,610051

出　　处：《中国计划生育学杂志》2021年第11期2350-2354,共5页Chinese Journal of Family Planning

摘　　要：目的:分析妊娠期妇女弓形虫(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)的筛查阳性与不良妊娠结局。方法:收集2019年1月-2020年1月本院行产前检查和TORCH血清学检测的3065例孕妇,年龄<35岁1725例,年龄≥35岁1340例,跟踪孕妇妊娠结局,失访229例,将2836例孕妇根据妊娠结局分为不良结局组(n=178)和正常结局组(n=2658),胶体金法检测血清中TOX、RV、CMV、HSV-Ⅰ、HSV-ⅡIgM抗体。结果:3065例孕妇中,TORCH-IgM感染98例,感染率为3.2%,其中CMV-IgM阳性率最高为2.0%,其次为HSV-Ⅰ-IgM、HSV-Ⅱ-IgM、TOX-IgM和RV-IgM,阳性率分别为0.5%、0.4%、0.2%、0.2%。春、秋季CMV-IgM阳性率高于夏、冬季,<35岁孕妇CMV-IgM、HSV-Ⅰ-IgM、HSV-Ⅱ-IgM阳性率高于≥35岁孕妇(P<0.05)。妊娠结局不良组TOX-IgM、RV-IgM、CMV-IgM、HSV-Ⅰ-IgM、HSV-Ⅱ-IgM阳性率均高于正常组(P<0.05)。logistic多因素回归分析显示,<35岁、TOX-IgM、RV-IgM、CMV-IgM、HSV-Ⅰ-IgM、HSV-Ⅱ-IgM阳性率为影响不良妊娠结局的独立危险因素(P<0.05)。结论:本次分析妊娠妇女TORCH感染中CMV感染较高,且TORCH感染与季节、年龄及妊娠结局有一定关系,提示孕前及孕早期行TORCH检测的重要意义。Objective:To analyze the serological screening results of toxoplasma gondii(TOX),rubella virus(RV),cytomegalovirus(CMV),and herpes simplex virus(HSV)of the pregnant women,and to study their relevant to their adverse pregnancy outcomes.Methods:3065 pregnant women who underwent prenatal examination and TORCH serological detection from January 2019 to January 2020 were selected as the research objects,among them,there were 1725 women<35 years old and 1340 women≥35 years old.These women were followed up,and 229 pregnant women were lost to follow-up.2836 pregnant women who had completed the followed up were divided into group A(178 women with adverse pregnancy outcomes)and group B(2658 women with normal pregnancy outcomes).The serum IgM antibody of TOX,RV,CMV,and HSV-Ⅰand HSV-Ⅱwere detected by colloidal gold method.Results:Among the 3065 pregnant women,98 cases were positive for TORCH IgM,with the infection rate of 3.2%.The highest positive rate was CMV IgM(2.0%),followed by HSV-ⅠIgM(0.5%),HSV-ⅡIgM(0.4%),TOX IgM(0.2%),and RV IgM(0.2%).The positive rate of CMV IgM of the pregnant women in spring and autumn was significantly higher than that of the pregnant women in summer and winter.The positive rates of CMV IgM,HSV-ⅠIgM,and HSV-ⅡIgM of the pregnant women<35 years old were significantly higher than those of the pregnant women≥35 years old(P<0.05).The positive rates of TOX IgM,RV IgM,CMV IgM,HSV-ⅠIgM,and HSV-ⅡIgM of the women in group A were significantly higher than those of the women in group B(P<0.05).Logistic multifactor regression analysis showed that<35 years old,and the positive rates of TOX IgM,RV IgM,CMV IgM,HSV-ⅠIgM,and HSV-ⅡIgM were the independent risk factors of adverse pregnancy outcomes of the pregnant women(P<0.05).Conclusion:CMV infection of the pregnant women among TORCH infection is higher.TORCH infection is closely related to the season,age of the women,and the pregnancy outcomes.Therefore,screening TORCH infection of the pregnant women before pregnancy and during the first tr

关 键 词：产前检查 弓形虫 风疹病毒 巨细胞病毒 单纯疱疹病毒 不良妊娠结局 

分 类 号：R71[医药卫生—妇产科学]