超声联合试验室检查对宫内胎儿TORCH感染的诊断价值研究

发布时间：2018-06-03 12:15

本文选题：超声 + 宫内感染　；参考：《中华医院感染学杂志》2017年21期

【摘要】：目的探讨超声联合试验室检查对胎儿宫内TORCH感染的诊断价值。方法回顾性分析2013年5月-2016年8月在医院接受孕检的孕妇临床资料,所有孕妇均采用酶联免疫吸附法对其血清TORCH特异性抗体进行检测,同时接受超声检查观察胎儿发育情况,观察试验室检查诊断胎儿宫内TORCH感染的准确性,分析超声对宫内感染胎儿发育的预测价值。结果 110名胎儿中,确诊发生宫内TORCH感染者18例,感染率为16.36%;110名孕妇中,血清抗TORCH IgM抗体阳性20例,阳性率18.18%;感染孕妇血清IL-6、IL-8、TNF-α、CRP和IgM水平均高于未感染孕妇(P0.001);血清IL-6、IL-8、TNF-α、CRP和IgM水平对胎儿宫内TORCH感染诊断的灵敏度为82.5%、84.9%、75.3%、68.7%、80.2%特异度为80.3%、78.5%、70.1%、73.2%、78.8%,诊断指数159.3%、165.2%、142.6%、135.2%、160.5%;通过超声对确诊为宫内TORCH感染胎儿进行诊断,发现发生胎儿发育异常者4例,其中包括脐膨出1例,单脐动脉肾盂积水1例,发育迟缓2例,与胎儿出生后诊断结果一致。结论 IL-6、IL-8、TNF-α、CRP和IgM水平对胎儿宫内TORCH感染有较好的诊断价值,且结合超声影像学结果可预测胎儿的发育情况,具有良好的临床应用价值。
[Abstract]:Objective to evaluate the diagnostic value of ultrasound combined with laboratory examination in fetal intrauterine TORCH infection. Methods the clinical data of pregnant women who underwent pregnancy examination in hospital from May 2013 to August 2016 were analyzed retrospectively. The serum TORCH specific antibodies were detected by enzyme-linked immunosorbent assay (Elisa) and the fetal development was observed by ultrasound. To observe the accuracy of laboratory examination in the diagnosis of fetal intrauterine TORCH infection and to analyze the predictive value of ultrasound for fetal development of intrauterine infection. Results among the 110 fetuses, 18 cases of intrauterine TORCH infection were diagnosed, and the infection rate was 16.3636%. Among 110 pregnant women, 20 cases were positive for anti TORCH IgM antibody. The positive rate was 18.18; the serum levels of IL-6 + IL-8TNF- 伪 and IgM in pregnant women with infection were higher than those in uninfected pregnant women (P 0.001N); the sensitivity of serum IL-6IL-8TNF- 伪 and IgM to the diagnosis of intrauterine TORCH infection was 82.5%, and the sensitivity of 85.38.70.2% was 80.38.78.20.The specificity was 80.38.50.The diagnostic index was 159.35.25.22.62.65.20.The diagnostic index was 159.35.25.2142.62.65.The diagnostic index was 159.35.22.62.65.20.55, and the diagnostic index was 159.35.22.62.65.20.5.The specificity was 80.38.35%, and the diagnostic index was 159.35.22.62.65.20.5.The positive rate of TNF- 伪 and TNF- 伪 in pregnant women was 78.35%. 4 cases of fetal dysplasia were found, including 1 case of omphalocele, 1 case of hydronephrosis of single umbilical artery and 2 cases of stunting. Conclusion IL-6 and IL-8 TNF- 伪 CRP and IgM levels are valuable in the diagnosis of fetal intrauterine TORCH infection. Combined with the results of ultrasound imaging, the fetal development can be predicted and has a good clinical application value.
【作者单位】：青海省妇幼保健院超声科;青海省人民医院超声科;
【基金】：青海省自然科学基金资助项目(QH2818222)
【分类号】：R445.1;R714.5

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