育龄妇女TORCH感染的诊断指标及其临床意义

目的　探讨TORCH血清学检测各指标在诊断TORCH感染中的应用。方法　收集 10 80例育龄妇女外周血血清标本分别应用ELISA捕获法检测TORCH -IgM、ELISA双抗体夹心法定量检测TORCH -IgG以及PCR技术检测 2 0 6例HCMV -IgM阴性且HCMV -IgG阳性标本的HCMV -DNA。结果　TOXO -IgM阳性率为 1.76 % (16 /90 9) ,RV -IgM阳性率为 0 .33% (3/90 2 ) ,HCMV -IgM阳性率为 1.6 4 % (16 /930 )。TOXO -IgG为 3.74 % (34/90 8) ;RV -IgG为 6 7.0 7%(6 0 5 /90 2 ) ;HCMV -IgG为 91.0 6 % (84 5 /92 8)其阳性率接近国内有关文献报道。HCMV -IgG(+)组和HCMV -IgG(++)组的DNA阳性率分别为 1.39%和 1.5 0 % ,HCMV -IgG(+++)组的DNA阳性率为 7.35 % ,HCMV -IgG阳性 (+)组和HCMV -IgG阳性 (++)组HCMV -DNA的阳性率无显著性差异 (P >0 .0 5 ) ;HCMV -IgG阳性 (+)组和HCMV -IgG阳性(++)组与HCMV -IgG阳性 (+++)组HCMV -DNA的阳性率均有显著性差异 (P <0 .0 5 )。结论　捕获法检测血清TORCH -IgM特异性高 ,假阳性率低 ,是可靠的辅助的诊断指标之一。在HCMV -IgG滴度较高时 ,提示有HCMV近期感染的可能。

The diagnostic markers of TORCH infection and their clinical value

Objective: To discuss the usage of several plasma markers in diagnosis of TORCH infection. Methods: ELISA capture method was applied to detect TORCH-IgM and ELISA double antibodies combination method was applied to quantificationally detect TORCH-IgG of blood plasma samples of 1080 women. In addition, PCR technique was applied to detect HCMV-DNA in 206 plasma samples which were HCMV-IgM negative and HCMV-IgG positive. Results The positive rates of TOXO-IgM, RV-IgM and HCMV-IgM were respectively 1.76% (16/909), 0.33% (3/902) and 1.64% (16/930). The positive rates of TOXO-IgG, RV-IgG and HCMV-IgG were respectively 3.74% (34/908), 67.07% (605/902) and 91.06% (845/928). They were similar to certain native reports. The detection rates of HCMV-DNA were individually 1.39%, 1.50% and 7.35% in HCMV-IgG (+) group, HCMV-IgG (++) group and HCMV-IgG (+++) group. No statistical difference of DNA positive rates existed between HCMV-IgG (+) group and HCMV-IgG (++) group (P>0.05). However, the positive rates of HCMV-DNA were statistically different between HCMV-IgG (+) group and HCMV-IgG (+++) group (P<0.05). It was the same between HCMV-IgG (++) group and HCMV-IgG (+++) group (P<0.05). Conclusions Detection of plasma TORCH-IgM by capture method was one of the reliable diagnostic markers because of high specificity and low false positive rates. High HCMV-IgG concentration may suggest recent HCMV infection.