新生儿先天性症状性巨细胞病毒感染与母源性原发及复发CMV感染的相关性

发布时间：2018-11-17 18:58

【摘要】：目的:探讨新生儿先天性症状性巨细胞病毒(Cytomegalovirus,CMV)感染与母源性原发及复发CMV感染的相关性。方法:选取48例先天性症状性CMV感染新生儿及其母亲为感染组,30例未感染CMV新生儿及其母亲为阴性组,应用化学发光法(CLIA)检测两组病例外周血特异性抗体IgM/IgG(CMV-IgM/IgG)及CMV-IgG亲合力水平,荧光定量PCR法检测两组母亲乳汁、新生儿外周血及尿液中CMV-DNA含量,分析比较其检测结果的差异并回顾性分析比较了两组母亲孕早期CMV-IgG的浓度水平与本次结果的差异。结果:感染组母亲外周血CMV-IgG抗体水平及乳汁CMV-DNA阳性率显著高于对照组,差异有统计学意义(P均0.01);病例组患儿与母亲CMV特异性IgG抗体比值小于对照组,差异有统计学意义(P均0.01);感染组子母间IgG测定值为负相关性,差异有统计学意义(P0.01);阴性组子母间IgG测定值为正相关性,差异有统计学意义(P0.01);感染组母亲孕早期CMV-IgG浓度水平显著低于本次结果,差异有统计学意义(P0.01);阴性组母亲孕早期CMV-IgG浓度水平与本次结果无显著性差异(P0.05)。结论:孕妇体内CMV活化或再感染导致CMV-IgG水平升高,是新生儿先天性症状性CMV感染的高危因素,孕期应关注CMV-IgM/IgG动态监测。
[Abstract]:Objective: to investigate the relationship between congenital symptomatic cytomegalovirus (Cytomegalovirus,CMV) infection and maternal primary and recurrent CMV infection. Methods: 48 neonates and their mothers with congenital symptomatic CMV infection were selected as infection group, and 30 uninfected CMV newborns and their mothers were selected as negative group. The levels of specific antibody IgM/IgG (CMV-IgM/IgG) and CMV-IgG in peripheral blood of two groups were detected by chemiluminescence assay (CLIA), and the content of CMV-DNA in mother's milk, newborn blood and urine were detected by fluorescence quantitative PCR method. The differences of CMV-IgG levels in the first trimester of pregnancy between the two groups were analyzed and compared retrospectively. Results: the levels of CMV-IgG antibody in peripheral blood and the positive rate of CMV-DNA in milk of infected mothers were significantly higher than those in control group (P0.01). The ratio of CMV specific IgG antibody to mother in the case group was significantly lower than that in the control group (P0.01), and the IgG level in the infected group was negatively correlated with that of the mother (P0.01). There was a positive correlation between mothers and mothers in negative group, the difference was statistically significant (P0.01), and the level of CMV-IgG in infected mothers was significantly lower than that in the first trimester of pregnancy (P0.01). There was no significant difference in the level of CMV-IgG between the mothers in the negative group and this result (P 0.05). Conclusion: the activation or reinfection of CMV in pregnant women leads to the increase of CMV-IgG level, which is a high risk factor for congenital symptomatic CMV infection in neonates. The dynamic monitoring of CMV-IgM/IgG should be paid attention to during pregnancy.
【作者单位】：宁夏医科大学总医院医学实验中心;
【基金】：宁夏自然科学基金项目(NZ14148)
【分类号】：R722.13

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