B组溶血性链球菌抗体对母婴预后的影响  

The Influence on the Maternal and Neonatal Outcome by the Type Ⅲ Antibody of Group B Streptococcus

作　　者：马延敏[1] 申阿东[2] 张桂荣[2] 王咏红[2] 王维[1] 吴连方[1] 黄醒华[1] 杨永弘[2] 

机构地区：[1]首都医科大学附属北京妇产医院,100006 [2]北京市儿科研究所微生物免疫室

出　　处：《中华围产医学杂志》2002年第4期266-268,共3页Chinese Journal of Perinatal Medicine

基　　金：国家九五攻关基金资助项目 (基金编号 96 -90 4-0 6 -0 7)

摘　　要：目的　了解母婴配对血清中抗 B组溶血性链球菌 (GBS) 型荚膜多糖 Ig G抗体的水平对妊娠结局的影响。　方法　 1997年 12月～ 2 0 0 0年 12月期间 ,在北京妇产医院就诊并作 GBS筛查的 GBS阳性孕妇 2 8例为研究组 ,同期阴性者 46例为对照组。留取孕期不同阶段 (≤孕 2 0周、2 0 + 1 ～2 4周、34周～分娩 )阴道 /肛周拭子做 GBS细菌培养 ,产时留取母血 3m l、脐血 5 m l离心后的血清 ,用 EL L ISA法测定 GBS 型抗荚膜多糖抗体的水平。　结果　 74例孕妇中 GBS阳性 2 8例 ,2 8例中妊娠期糖尿病、糖耐量减低、胎儿宫内生长受限、胎膜早破、先兆早产、新生儿窒息的发生率无统计学差异。产妇及新生儿脐血血清的抗 GBS 型荚膜多糖 Ig G抗体的平均浓度为分别为 3.1mg/L、2 .3mg/L,二者的相关系数为 0 .86。 GBS阳性的产妇及其新生儿的抗体浓度分别为 1.6 mg/L、1.1m g/L;而阴性产妇及其新生儿的抗体浓度分别为 3.9mg/L、3.0 4m g/L,经统计学分析 ,两组间的抗体水平差异有非常显著性 (P<0 .0 0 1)。抗体浓度 >2 m g/L 的产妇 ,不带菌者占 90 .0 % (36 /4 0 ) ,新生儿中不带菌者占 97.0 % (32 /33)。　结论　母亲血清中抗 GBS抗体约有 73%通过胎盘 ,垂直传播给胎儿。我国产妇及新生儿血清中抗Objective To learn the influence on the outcome of the pregnant by measuring the type Ⅲ antibody of Group B Streptococcus(GBS). Methods During December 31, 1997 to December 31, 2000, 28 pregnant women whose GBS screening were positive were selected as study group while 46 negative as control group. Vaginal swab cultures were conducted in 74 pregnant women at different gestational periods(before 20 gestational weeks, 20~28 weeks and after 34 weeks). After birth maternal and cord blood samples were collected immediately for the test of GBS IgG antibody with ELISA method. Results 28 of 74 women(37.8%)were GBS culture positive in the antenatal screening. The obstetrical complications such as gestational diabetes millitus, impaired glucose tolerance test, fetal growth retardation, premature rupture of membrane, threatened premature labor and asphyxia of newborn have no significant difference between the GBS carrier group and non-carrier group. The result was same for the newborns. The antibody(IgG)of GBS value of the 74 pairs of maternal and cord blood samples showed that the values of IgG in maternal blood samples and cord blood samples were (3.1±2.2) mg/L and (2.3±1.8) mg/L, respectively,r=0.86,P<0.001. In the group of GBS carrier mothers, the value of GBS IgG was (1.6±0.7) mg/L and in the group of non-carrier mothers it was (3.9±2.4) mg/L,P<0.001. In the group of GBS carrier newborns the value of GBS IgG was (1.1±0.7) mg/L while it was (3.0±1.8) mg/L in non-carrier newborns, P<0.001. There are 36 non-carrier women among those 40 women whose IgG value was beyond 2 mg/L(36/40, 90.0%), while 32 non carrier newborns in those 33 newborns(32/33, 97.0%). Conclusions GBS antibody (IgG)may be a protective antibody which can keep the mothers and the newborns from being infected. About 73% GBS antibody in maternal serum transmitted through the placenta to the infant.

关 键 词：B组溶血性链球菌抗体 免疫球蛋白G 妊娠结局 围产期感染 

分 类 号：R714.7[医药卫生—妇产科学]