先天性巨细胞病毒感染胎儿的超声与妊娠结局临床分析  

The clinical analysis of ultrasound and pregnancy outcome of congenital cytomegalovirus infection

作　　者：杨坤祥 陈剑虹 程琳 蔡伟奕 Yang Kunxiang;Chen Jianhong;Cheng Lin;Cai Weiyi(Prenatal Diagnosis Center,Huizhou First Maternal and Child Health Car Hospital,Huizhou 516003,Guangdong,China)

机构地区：[1]惠州市第一妇幼保健院产前诊断中心,广东惠州516003

出　　处：《中国产前诊断杂志（电子版）》2022年第3期15-20,共6页Chinese Journal of Prenatal Diagnosis(Electronic Version)

基　　金：惠州市科技计划项目(2020Y035)。

摘　　要：目的分析先天性巨细胞病毒(congenital cytomegalovirus,CMV)感染的胎儿或新生儿的超声与妊娠结局的临床特征,为孕妇巨细胞病毒感染的产前诊断和遗传咨询提供临床数据。方法回顾性分析惠州市第一妇幼保健院2017年1月至2019年12月超声检查提示侧脑室增宽、胼胝体发育不良、Blach-pounch囊肿、肠管回声增强、胎儿生长受限等的700例孕妇为研究对象,实时荧光定量聚合酶链反应(qRT-PCR)检测孕妇羊水及新生儿尿液CMV DNA载量,化学发光法检测孕妇及新生儿外周血CMV IgM和CMV IgG抗体。分析先天性CMV感染胎儿的超声与实验室筛查的临床特征。结果(1)700例超声有侧脑室增宽、胼胝体发育不良、Blach-pounch囊肿、肠管回声增强、胎儿生长受限孕妇中检测出18例先天性CMV感染胎儿,检出率为2.57%。18例中,5例确诊CMV宫内感染后终止妊娠;2例继续妊娠过程中复查侧脑室增宽进展后终止妊娠;1例继续妊娠过程中磁共振成像(MRI)复查提示胚胎性脑病,终止妊娠;10例选择继续妊娠并分娩。(2)2项及以上超声异常者先天性CMV感染率高于单项超声异常者[3.27%(10/306)与2.03%(8/394),χ^(2)=1.05,P>0.05]。脑部超声异常的胎儿先天性CMV感染率高于非脑部超声异常的胎儿[3.42%(14/409)与1.37%(4/291),χ^(2)=2.85,P>0.05]。结论先天性CMV感染容易引起不良妊娠结局,胎儿侧脑室增宽、胼胝体发育不良、Blach-pounch囊肿、肠管回声增强、胎儿生长受限等超声异常在预测胎儿先天性CMV感染有一定的临床价值。Objective To analyze the clinical characteristics of ultrasound and pregnancy outcome of congenital cytomegalovirus(CMV)infection fetuses or newborns,and to provide clinical data for prenatal diagnosis and genetic counseling of pregnant women with CMV infection.Methods A retrospective analysis of our hospital between January 2017 and December 2019,ultrasound tip broadening lateral ventricle,corpus callosum dysplasia,Blach-pounch cyst,insufflate echogenicity,fetal growth restriction of 700 cases of pregnant women as the research object,such as fluorescence quantitative real-time polymerase chain reaction(qRT-PCR)to detect amniotic fluid and neonatal urine CMV DNA loads,chemiluminescence detection of pregnant women and newborn peripheral blood CMV IgG and IgM antibody.To analyze the clinical features of ultrasound and laboratory screening in fetuses with congenital CMV infection.Results(1)700 pregnant women with ultrasound abnormalities such as lateral ventricle enlargement,corpus callosum dysplasia,black cyst,intestinal echo enhancement,fetal growth restriction,etc.,18 cases of congenital CMV infection were detected by PCR,the detection rate was 2.57%.Of these 18 cases,5 cases terminated pregnancy after diagnosis of CMV intrauterine infection.Two cases of them,pregnancy was terminated after reexamination of lateral ventricle widening and progression during pregnancy.One cases of them,fetal encephalopathy was suggested by magnetic resonance imaging(MRI)reexamination during the process of continuing pregnancy and pregnancy was terminated.Ten cases chose to continue pregnancy and deliver.(2)The rate of congenital CMV infection in patients with two or more ultrasound abnormalities was higher than that in patients with single ultrasound abnormalities[3.27%(10/306)and 2.03%(8/394),χ^(2)=1.05,P>0.05].The rate of congenital CMV infection in fetuses with abnormal brain ultrasound was higher than that in fetuses without abnormal brain ultrasound[3.42%(14/409)and 1.37%(4/291),χ^(2)=2.85,P>0.05].Conclusion Congenital CMV in

关 键 词：巨细胞病毒感染 胎儿 超声 QRT-PCR 妊娠结局 

分 类 号：R714.53[医药卫生—妇产科学]