输卵管妊娠患者生殖道巨细胞病毒和沙眼衣原体的测定

目的：探讨巨细胞病毒和沙眼衣原体感染与输卵管妊娠的关系。方法：应用酶联合免疫吸附试验法检测95例输卵管妊娠患者（异妊娠组）和42例际件切除术,无输卵管妊娠史的卵巢囊肿患者（对照组）血清中抗巨细胞病毒IgM,应用聚合酶链反应技术测定生殖道组织中巨细胞病毒gH基因和沙眼衣原体热休克蛋白基因。结果：异位妊娠组抗巨细胞病毒IgM阳性14例,阳性率为15％,对照组阳性1例,巨细胞病毒gH基因阳性18例,阳性率为19％,对照组则2例阳性,两组比较差异有差异性（P＜0．05）。异位妊娠组沙眼衣原体热休克蛋白基因阳性25例,阳性率为26例,对照组则阳性2例,两组比较,差异有显著性（P＜0．05）。结论：巨细胞病毒和沙眼衣原体感染可能与输卵管妊娠的发生有关。     

孕妇及其新生儿HSV、EBV和HCMV感染状况的PCR分析

目的:调查孕妇及其新生儿人疱疹病毒包括人单纯疱疹病毒1型(HSV-1)、EB病毒(EBV)和人巨细胞病毒(HCMV)的感染情况及母婴垂直传播状况,为新生儿病毒感染的预防提供依据。方法:收集59例单胎妊娠孕妇外周静脉血及其配对新生儿脐带血,提取DNA,巢式PCR检测HSV-1、EBV和HCMV感染情况。结果:59例孕妇血中HSV-1、EBV和HCMV阳性率分别为27.1%、11.9%和11.9%,新生儿脐带血HSV-1、EBV和HCMV阳性率分别为13.6%、20.3%和3.4%。表明3种疱疹病毒均可通过母婴垂直传播引发新生儿先天感染。结论:妊娠期有必要进行疱疹病毒的筛查,对于病毒的早期防控有一定的指导意义。     

一氧化氮与妊娠早期人巨细胞病毒宫内活动性感染的关系

目的　探讨一氧化氮与妊娠早期人巨细胞病毒 (HCMV)宫内活动性感染的关系。方法　选取既往有自然流产、死胎、胎儿畸形、胎儿生长受限等异常妊娠史并行人工流产术的早孕妇女 81例 ,应用逆转录 聚合酶链反应技术检测其胎盘绒毛组织HCMV mRNA的表达 ;酶联免疫吸附试验法测定其血清HCMV IgM ;原位杂交法检测其蜕膜巨噬细胞诱生型一氧化氮合酶 (iNOS) mRNA的表达并行定量分析。结果　 (1) 81例孕妇中有 6例胎盘绒毛组织HCMV mRNA阳性 ,14例血清HCMV IgM阳性 ,阳性率为 17 3 % (14/ 81)。依据HCMV mRNA与HCMV IgM检测结果 ,81例孕妇分为 3组 :Ⅰ组 :HCMV mRNA与HCMV IgM均阳性 5例 ,其宫内传播率为 3 5 7% (5 / 14) ;Ⅱ组 :HCMV mRNA阴性而HCMV IgM阳性 9例 ;Ⅲ组 :HCMV mRNA与HCMV IgM均阴性 66例。另有 1例HCMV IgM阴性者其胎盘绒毛组织HCMV mRNA阳性。 (2 )Ⅰ组患者蜕膜iNOS mRNA呈强表达 ,其吸光度值为 0 412±0 0 19,明显高于Ⅱ组的 0 172± 0 0 3 3与Ⅲ组的 0 167± 0 0 3 3 ,Ⅰ组与Ⅱ组及Ⅲ组比较 ,差异有显著性(P <0 0 5 ) ;Ⅱ组与Ⅲ组比较 ,差异无显著性 (P >0 0 5 )。 1例HCMV IgM阴性而胎盘绒毛组织HCMV mRNA阳性者 ,蜕膜iNOS mRNA也呈强表达 ,其吸光度值为 0 40 3。结论　一氧化氮可     

产前母血中检出弓形体、巨细胞病毒及Ⅱ型单纯疱疹病毒者围产儿结局的初步探讨

目的 从围产儿结局探讨产前弓形体、巨细胞病毒及单纯疱疹病毒Ⅱ型DNA多聚酶链反应(PCR)检测的必要性.方法 采用PCR技术对母血、胎盘组织及(或)脐血进行弓形体、巨细胞病毒及单纯疱疹病毒Ⅱ型病原体检测.结果 1 141例孕妇产前弓形体、巨细胞病毒及单纯疱疹病毒Ⅱ型检测中,97例检出病原体,检出率8.50%,弓形体、巨细胞病毒及单纯疱疹病毒Ⅱ型的检出率分别为4.82%,2.72%及2.28%.围产儿结局不同的两组,其胎盘组织及(或)脐血中病原体的检出率分别为17.65%及60.00%(P＜0.05).结论 孕妇产前弓形体、巨细胞病毒及单纯疱疹病毒Ⅱ型检测很有必要,母血阳性者应将胎盘及其附属物送检;对母血阳性的围产儿,应密切随访.     

自然流产妇女人巨细胞病毒感染的调查

采用酶联免疫吸附法（ＥＬＩＳＡ），对自然流产的６５８例妇女血清进行了人巨细胞病毒（ＨＣＭＶ）ＩｇＧ、ＩｇＭ的检测，并和正常妊娠妇女作比较；应用ＥＬＩＳＡ对１５例流产后绒毛进行ＨＣＭＶ－ＩｇＧ、ＩｇＭ检测。结果显示：流产组ＨＣＭＶ－ＩｇＧ，ＨＣＭＶ－ＩｇＭ，ＨＣＭＶ－ＩｇＧ与ＨＣＭＶ－ＩｇＭ双阳阳性率分别为２７．２０％、１３．８３％、８．５１％，其中ＨＣＭＶ－ＩｇＭ、ＨＣＭＶ－ＩｇＧ及ＨＣＭＶ－ＩｇＭ双阳阳性率与正常孕妇相比，差异有显著性（Ｐ＜０．０１）；１５例流产绒毛，阳性率８０％。说明ＨＣＭＶ通过胎盘传给胎儿，引起流产。孕妇原发与激发感染与自然流产有相关性，ＨＣＭＶ－ＩｇＭ和ＨＣＭＶ－ＩｇＧ与ＨＣＭＶ－ＩｇＭ双阳阳性率与发生流产次数成正相关。     

病原体及巨细胞病毒感染与输卵管妊娠的关系

目的　探讨解脲支原体、沙眼衣原体、巨细胞病毒感染与输卵管妊娠的关系。方法应用PCR技术 ,检测 12 8例输卵管妊娠患者 (观察组 )和 5 0例行附件切除术、无输卵管妊娠史的卵巢囊肿患者 (对照组 )的宫颈分泌物和输卵管组织中解脲支原体、沙眼衣原体、巨细胞病毒DNA。结果(1)观察组 5 6例宫颈分泌物检测出解脲支原体DNA ,阳性率为 4 3 8% ,对照组 10例宫颈分泌物检测出解脲支原体DNA ,阳性率为 2 0 0 % ;观察组 4 8例输卵管组织检测出解脲支原体DNA ,阳性率为37 5 % ,对照组 5例输卵管组织检测出解脲支原体DNA ,阳性率为 10 0 % ;两组比较 ,差异有极显著性 (P <0 0 1) ;(2 )观察组 35例宫颈分泌物检测出沙眼衣原体DNA ,阳性率为 2 7 3% ,对照组 5例宫颈分泌物检测出沙眼衣原体DNA ,阳性率为 10 0 % ;观察组 34例输卵管组织检测出沙眼衣原体DNA ,阳性率为 2 6 6 % ,对照组 3例输卵管组织检测出沙眼衣原体DNA ,阳性率为 6 0 % ;两组比较 ,差异有显著性 (P <0 0 5 ) ;(3)观察组 2 1例宫颈分泌物检测出巨细胞病毒DNA ,阳性率为 16 4 % ,对照组 3例宫颈分泌物检测出巨细胞病毒DNA ,阳性率为 6 0 % ;观察组 2 5例输卵管组织检测出巨细胞病毒DNA ,阳性率为 19 5 % ,对照组 2例输卵管组织检测出巨细胞病     

胸腺基质淋巴细胞生成素及相关因子在原因不明复发性流产中的表达

目的:探讨胸腺基质淋巴细胞生成素(TSLP)与原因不明复发性流产(URSA)的关系。方法:建立研究组自然流产小鼠模型(CBA/J×DBA/2)和对照组正常妊娠小鼠模型(CBA/J×Balb/c),采用免疫印迹(Western Blot)方法和实时荧光定量聚合酶链式反应(RT-PCR)方法检测绒毛、蜕膜组织中TSLP的表达;采用酶联免疫吸附双抗体夹心(ELISA)方法检测外周血TSLP、细胞因子白介素-4(IL-4)及干扰素-γ(IFN-γ)的表达;采用流式细胞仪检测调节性T细胞(Treg)表面FoxP3的表达。结果:RT-PCR法检测自然流产模型组绒毛组织中TSLP的表达低于正常妊娠模型组(P<0.05);Western Blot法分析显示自然流产模型组绒毛、蜕膜组织中TSLP的表达低于正常妊娠模型组(P<0.05);ELISA法检测自然流产模型组血清中TSLP、IL-4的表达低于正常妊娠模型组(P<0.05),而IFN-γ的表达较正常妊娠模型组未见明显增高(P>0.05);流式细胞仪检测自然流产模型组CD4+CD25+Treg和FoxP3的表达明显低于正常妊娠模型组(P<0.05)。结论:TSLP明显降低,可能是导致URSA患者母胎界面免疫耐受异常的重要原因。     

人细小病毒B19感染与自然流产关系的研究

目的：探讨人细小病毒Ｂ１９感染与自然流产之间的关系。方法：用巢式聚合酶链反应技术检测１０５例（病例组）自然流产胚胎组织标本中的Ｂ１９病毒ＤＮＡ，并取２０例胚胎组织和２０例胎肝作对照，Ｂ１９病毒阳性标本作合并ＴＯＲＣＨ感染的诊断。结果：病例组检出２６例阳性（２４．８％），对照组检出２例阳性（５．０％），（Ｐ＜０．０５）。２６例阳性标本中，５例合并巨细胞病毒（ＣＭＶ）感染，２例合并ＣＭＶ、单纯疱疹病毒感染。结论：Ｂ１９病毒感染可能是引起自然流产的重要原因。     

cFLIP在早期自然流产绒毛组织的表达及意义

目的:检测早期正常妊娠及自然流产绒毛组织中细胞凋亡抑制蛋白cFLIPmRNA及其蛋白产物的表达,分析并探讨cFLIP与自然流产的关系。方法:应用RT-PCR法及免疫组化SP法检测cFLIP mRNA及其蛋白产物在20例自然流产患者(研究组)绒毛组织的表达,以同期正常妊娠要求人工流产20例为对照组。结果:研究组绒毛组织中cFLIP mRNA及蛋白表达明显低于对照组,差异有统计学意义(P<0.01)。结论:细胞凋亡抑制蛋白cFLIP参与维持正常妊娠,绒毛组织中其表达下降可能在自然流产的发生中起重要作用。     

抑癌基因PTEN和抗氧化蛋白PeroxiredoxinⅡ在自然流产患者绒毛组织的表达及意义

目的:分析并探讨绒毛组织中抑癌基因PTEN和抗氧化蛋白PeroxiredoxinⅡ(Prx2)与自然流产的关系。方法:应用RT-PCR法及免疫组织化学SP法检测PTEN和Prx2蛋白及mRNA在30例自然流产患者(实验组)绒毛组织中的表达,并以同期非意愿妊娠要求人工流产的30例正常妊娠患者为对照组。结果:①实验组绒毛组织中PTEN和Prx2蛋白阳性表达率(70.0%,36.7%)明显低于对照组(93.3%,93.4%),差异有统计学意义(P<0.05)。②实验组绒毛组织中PTEN和Prx2 mRNA的表达(0.929±0.100,1.131±0.125)明显低于对照组(0.059±0.010,0.222±0.029),差异有统计学意义(P<0.05)。结论:PTEN和Prx2在自然流产患者绒毛组织中表达明显下降,说明可能与自然流产的发生有一定关系。     

Latent cervical virus infection as a possible cause of early abortion]

Cervical smears of 50 women who had an abortion were examined by dot-blot hybridization for human papillomavirus (HPV), herpes simplex virus (HSV) types 1 and 2, and cytomegalovirus (CMV) DNA. HPV DNA type 16 or 18 positivity was shown in 17.6% of the cases; in the aborted material, however, it amounted to 30.8%. IgM-positive titres were present in a few cases. In cervical smears of intact pregnancies, positivity for HPV DNA types 6 and 11 was detected in 9.5% and for the HSV DNA types 1 and 2 and CMV DNA in 48.0% of the cases. In this group of patients mostly positive IgM and IgG titers were present.     

用聚合酶链式反应技术检测孕妇与胎儿巨细胞病毒感染的研究

应用聚合酶链式反应（ＰＣＲ）技术检测了孕妇、羊水及脐血中巨细胞病毒（ＣＭＶ）ＤＮＡ。结果表明，１８６例中正常孕妇９８例血清中ＣＭＶＤＮＡ阳性２例。阳性率为２％，异常妊娠（死胎、胎儿畸形及产前咨询）孕妇８８例血清中ＣＭＶＤＮＡ阳性１４例，阳性率为１５．９％，两者差异有显著性，（Ｐ＜０．０１）。提示孕妇ＣＭＶ感染与死胎、胎儿畸形及异常妊娠史有关。通过检测羊水和脐血中ＣＭＶＤＮＡ，发现９例胎儿ＣＭＶ感染，其中３例畸形，２例死胎，１例自然流产，３例足月分娩。     

监测反复自然流产者血清HCMVIgM抗体及其绒毛组织DNA的研究

采用酶联免疫吸附测定法（ＥＬＩＳＡ）对８５例反复自然流产（ＲＳＡ）妇女及１０７例无流产史早孕妇女的血清进行ＨＣＭＶＩｇＭ、ＨＣＭＶＩｇＧ检测，应用ＰＣＲ技术检测部分绒毛组织ＤＮＡ，直接法制备绒毛细胞染色体。结果显示：ＲＳＡ组ＨＣＭＶＩｇＭ阳性率（５８．８２％），明显高于对照组（１５．８９％）（Ｐ＜０．０１）。说明孕妇原发性ＨＣＭＶ感染与ＲＳＡ有相关性；ＨＣＭＶＩｇＭ阳性与流产次数有密切关系；ＨＣＭＶ可以通过胎盘屏障感染胎儿，导致流产     

Herpes simplex virus infection in women with previous spontaneous abortion

We have carried out a retrospective clinical investigation of 45 women in the first and second trimester of pregnancy aiming to demonstrate the role of genital HSV infection in the genesis of spontaneous abortion (miscarriage). Latent HSV infection was diagnosed using the microneutralization test; asymptomatic HSV vaginal or cervical shedding was diagnosed with indirect immunofluorescence and cytological-Papanicolau staining. The results showed that the highest incidence of latent HSV type 2 infection (64%) occurred in women who had one or more spontaneous abortions, whereas this type of infection was found in only 5% of pregnant women of the control group. The incidence of asymptomatic cervical HSV type 2 infection was also considerably higher in patients with a history of spontaneous abortions. Our results indicate a possible aetiological connection between HSV and spontaneous abortion.     

Human papillomavirus infection and spontaneous abortion: a case–control study performed in Mexico

Objective

To investigate if HPV cervical infection is associated with spontaneous abortion in a Mexican population.

Study design

Case control study including 281 women from two Social Security Hospitals in Merida, Mexico. Cases were women with spontaneous abortion attending for curettage, and controls were pregnant women at term who attended for delivery. HPV molecular detection and typing of HPV 16, 18, 58 and 6/11 was performed on cervical samples, and TORCH serology IgM tests (against T. gondii, CMV, HSV) were performed on cases. Data were analyzed using Chi square, odds ratio and linear regression tests.

Results

HPV global prevalence was 19.8% (24.4% in cases and 15.2% in controls). HPV types 16 and 58 were the most frequently detected in both groups. Multiple HPV types concurrent infection were found in 31.4% of typified samples. Amongst cases 27.3% of HPV positive women reported at least one previous pregnancy loss; compared to 17.43% amongst HPV negative women. Nevertheless, HPV was not significantly associated with spontaneous or to repetitive abortion. Cases were 60.2% positive to any TORCH agent, although it was not significantly associated to referred miscarriage history. Spontaneous abortion was associated to a previous pregnancy loss and to women's age older than 35 years old. HPV infection was significantly associated to alcohol intake before pregnancy and to multiple sexual partners.

Conclusion

HPV cervical infection was not associated with spontaneous abortion. HPV in spontaneous abortion and other adverse pregnancy outcomes merits further study.     

Detection of cytomegalovirus,herpes virus simplex,and parvovirus b19 in spontaneous abortion placentas

Objective: This study aims to investigate the presence of Cytomegalovirus (CMV), herpes virus simplex (HSV), and parvovirus B19 (PVB19) in the placental tissue of patients who underwent abortions without an otherwise-defined aetiology.

Study design: This cross-sectional study was conducted in a high-risk obstetric maternity facility at a University Hospital in Belo Horizonte, Brazil, from January 2013 to December 2015. We included placenta samples obtained from spontaneous abortions of unknown aetiology. Seventy placenta samples were identified and were classified according to histopathological characteristics. All samples were analysed using immunohistochemistry and polymerase chain reaction for CMV, PVB19, and HSV. The clinical variables were collected from the medical records of patients to verify the association of infection with villitis. The patients were divided into the following groups: I) with villitis (n?=?28) and II) without villitis (n?=?42).

Methods: Immunohistochemistry used monoclonal anti-CMV antibody (NCL-CMVpp65, Leica Biosystems, Wetzlar, Germany), anti-PVB19 antibody (NCL-PARVO, Leica Biosystems, Wetzlar, Germany), and anti-HSV1/HSV2 antibodies (NCL-HSV-1 and HSV2, Leica Biosystems, Wetzlar, Germany). The data were analysed using the Statistical Package for Social Sciences (SPSS Inc, Chicago, IL) 19.0.

Results: Viral agents were detected in five patients (7.14%) in the villitis group. Three patients were positive for CMV, one for PVB19, and one for HSV type 2. Foetal and maternal complications were significantly higher in the group with villitis compared with those in the group without villitis (p?=?.002).

Conclusions: The prevalence of transplacental viral infections as a cause of spontaneous abortion should be considered high in the placenta with villitis. Thus, this study highlights the need for developing diagnostic tests to clarify the aetiology of abortion and foetal loss.     

Cervical and serum IgA and serum IgG antibodies to Chlamydia trachomatis and herpes simplex virus in threatened abortion: a prospective study

Summary. The aetiological role of Chlamydia trachomatis (CT) and herpes simplex virus (HSV) was investigated in 189 patients with threatened abortion. Assessment of infection was based on isolation, and on determination of serum immunoglobulin (Ig)G and IgA antibodies as well as cervical IgA antibody levels with new sensitive radioimmunoassay (RIA) techniques. One third of the women were delivered of a healthy infant and two thirds aborted, but the two groups were otherwise clinically similar. By isolation, only 2.7% of the patients were CT-positive, but increased cervical IgA antibody level to CT was detected in 41.3%. The mean level of these local antibodies was similar in both study groups, but the mean levels of serum IgA and IgG antibodies were somewhat higher in the patients who aborted although the difference was not significant. None of the cervical specimens was positive for HSV by isolation but the cervical IgA antibody level to HSV was raised in 47.1% of the patients. Both cervical and serum IgA antibody levels to HSV were significantly raised among the patients who aborted, but there were no differences between the patients with spontaneous abortion and those with a blighted ovum. There was no clear association between CT and abortion, but an association between HSV and abortion is possible. The incidence of raised levels of both CT and HSV IgA antibodies in the cervix was surprisingly high in both groups and the significance of this finding remains to be investigated.