金叶败毒颗粒对HCMV感染及母婴垂直传播的临床疗效研究

采用ELISA法筛查育龄妇女2320例及孕妇3488例血清中人巨细胞病毒（HCMV）IgM、IgG，并以IgM阳性者作为研究对象；采用RT－PCR技术检测孕中期脐血、羊水、孕晚期脐血中晚期HCMV－mRNA，检测胎儿先天性感染。采用金叶败毒颗粒、更昔洛苇治疗HCMV感染并与对照组（IgM自然转阴组）比较IgM转阴率及垂直传播率。结果表明：对育龄妇女金叶败毒颗粒治疗组、更昔洛韦治疗组其HCMV－IgM转阴率分别为81．32％、100％，明显高于对照组（48．08％），差异具有极显著意义（P＜0．001）；两治疗组之间差异无显著意义。对孕妇金叶败毒颗粒治疗组其HCMV－IgM转阴率为80．91％，明显高于对照组（39．81％），差异具有极显著意义（P＜0．001）；金叶败毒治疗组母婴传播率为19．64％，明显低于对照组（47．37％），差异具有显著意义（P＜0．05），。提示；金叶败毒颗粒是治疗HCMV感染安全、有效的药物，能降低胎儿先天性HCMV感染率，对孕妇HCMV感染具有独特的临床应用价值。     

长沙地区母婴HCMV感染的分子流行病学初步研究

The detection of HCMV-IgG, IgM in plasma by ELISA and DNA in plasma and P(C) BMCs from mothers and their newborns by PCR was carried out. Positive HCMV-IgG, HCMV-IgM, P(C)BMCs HCMV DNA and plasma HCMV DNA were demonstrated in 119(95.2%), 7(5.6%), 27(21.6%) and 14(11.2%) in 125 mothers and 117(93.6%), 1(0.8%), 18(14.4%) and 7(5.6%) in their mewborns, respectively. There were significant differences among the positive rate of newborn's HCMV-IgM, plasma HCMV DNA and CBMCs HCMV DNA (P < 0.05), but the difference between HCMV-IgM and plasma HCMV DNA had no statistic significance (P > 0.05). This study suggests that HCMV-IgG and CBMCs HCMV PCR are preferable epidemiological index of HCMV infection of pregnant women and newborns respectively.     

A clinical study of cytomegalovirus infections during pregnancy

Summary Enzyme-linked Immunosorbent Assay (ELISA) was adopted to detect the human cytomegalovirus (HCMV) specific IgG, IgM in the blood samples of 216 pregnant women and the umbilical cord blood, as well as the HCMV antigen in the urine specimens of 91 newborn infants. Emphasis was put on the occurrence of cytomegalovirus infection during pregnancy and influence on both the mother and the infant. Our experimental results showed that HCMV IgG positive rate in the maternal sera as well as in cord sera was 93.98%; HCMV IgM positive rates were 8.8% in maternal sera and 3.7% in cord sera, respectively. In maternal sera IgG-positive group, 31.6% cord sera showed also HCMV IgG positive results. In 91 urine specimens of newborn infants, HCMV-Ag positive specimens accounted for 10.98% (10 cases). The rates of abortion, congenital malformation, stillbirth, premature fetal death, and intrauterine growth retardation (IUGR) were all apparently higher in the HCMV-IgM positive pregnant group than in the HCMV-IgM negative group. The infants of HCMV-IgM positive mothers also showed lower birth weight, height, biparietal diameter, suboccipitobregmatic diameter, occipitofronatal diameter, occipito-mental diameter than the infants of HCMV-IgM negative mothers. Meanwhile, the growth and development indices of the former showed a tendency to decrease. Placenta histological examination showed thac HCMV-IgM positive group had a higher incidence of pathological changes than HCMV-IgM negative group. Altogether, there were 8 cases of cogenital infections.     

孕妇胎儿间巨细胞病毒感染的探讨

目的　探讨人巨细胞病毒（ＨＣＭＶ） 活动性感染对胎儿的影响;方法　采用ＥＬＩＳＡ 法对不同组别的妇女检测ＨＣＭＶ－ ＩｇＡ两种抗体;结果　试验组ＩｇＡ 检出率高于Ｉｇ Ｍ,差异显著,对照组无差异,对妊娠早期ＨＣＭＶ 活动性感染追踪观察至生产６４ 例,发现各种异常占２５ ％ ,与对照组对比差异显著; 结论　ＨＣＭＶ 活动性感染妨碍胎儿发育,对准备受孕或受孕早期的妇女,检测ＨＣＭＶ 特异性ＩｇＭ、ＩｇＡ 抗体,可预测先天性ＨＣＭＹ 感染所致胎儿发育异常的危险性     

人巨细胞病毒活动性感染的分析

目的：调查人类巨细胞病毒（HCMV）活动性感染人群的分布及流行病学特征，为预防和诊治HCMV活动性感染提供证据。方法：用ELISA法测定血清中HCMV活动性感染的特异性抗体HCMV-IgM，并对HCMV-IgM检测人群进行分析。结果：90例健康人群血清HCMV活动性感染率为0，5315例孕妇血清HCMV-IgM检测中有303例为阳性，HCMV活动性感染率平均为5.70%,但孕妇HCMV活动性感染率有逐年下降趋势；51例不明原因的黄疸患者，16例器官移植患者、3例发热待查患者，HCMV活动性感染率分别为3.92%，12.5%。结论：移植患者、孕妇、不明原因的黄疸患者易受HCMV活动性感染，临床上应将其作为高危人群常规筛查HCMV-IgM。     

长沙地区母婴HCMV感染的分子流行病学初步研究

利用ELISA及PCR技术对长沙地区 12 5对母、婴HCMV IgG ,IgM及HCMV DNA进行了检测。结果显示 :在 12 5对母、婴中 ,HCMV IgG阳性率分别为 95 .2 % (119/ 12 5 )和 93.6 % (117/ 12 5 ) ,HCMV IgM阳性率分别为 5 .6 % (7/12 5 )和 0 .8% (1/ 12 5 ) ,血浆HCMVDNA阳性率分别为 11.2 % (14/ 12 5 )和 5 .6 % (7/ 12 5 ) ,P(C)BMCsHCMVDNA阳性率分别为 2 1.6 % (2 7/ 12 5 )和 14.4% (18/ 12 5 )。新生儿CBMCS HCMVDNA阳性率显著高于HCMV IgM及血浆HCMVDNA的阳性率 (P <0 .0 5 ) ,而血浆PCR与IgM阳性率差异无显著性意义 (P >0 .0 5 )。新生儿CBMCSHCMVDNA用于判断其先天性感染的灵敏度为 81.8%。表明CBMCSHCMVDNA与血浆HCMV IgG分别为新生儿及产妇HCMV感染的较好的流行病学指标。     

孕妇TORCH感染与胎儿畸形的关系

目的: 探讨孕妇TORCH感染与胎儿畸形的关系. 方法: 采用酶联免疫吸附试验 (ELISA)法检测1000例孕妇血清TORCH的特异性抗体IgM,对检测抗体阳性者和有畸胎史、不良孕产史的孕妇,用PCR法来检测TORCH DNA. 结果: 孕妇TORCH IgM阳性率为11.6%,其TOX, RV, HCMV, HSV IgM阳性率分别为3.60%, 2.50%, 3.40%, 2.10%;母婴垂直传播率为33.33%,其中TOX, RV, HCMV, HSV的垂直传播率分别为43.33%, 26.32%, 34.62%, 18.18%;孕妇妊娠期间有上感症状者感染TORCH IgM阳性率21.51%显著高于无上感症状者9.34%(P<0.01);有畸胎史TORCH IgM阳性率42.10%、不良孕产史25.40%,显著高于正常妊娠者8.13%(<0.01)TORCH感染孕妇其胎儿畸形率12.37%显著高于无感染组1.07% (<0.01) 结论: 孕妇TORCH感染是导致胎儿畸形的重要因素.     

孕产妇及胎婴儿巨细胞病毒感染的分析

采用间接免疫酶组化法检测1253例孕妇和40例有反复流产、畸胎、死胎史的优生咨询者及14例孕妇巨细胞病毒IgM(HCMV-IgM)阳性的新生儿脐血的HCMV-IgM。结果:孕妇HCMV-IgM阳性率为8.06％,16例反复流产者阳性3例,13例畸胎史者阳性5例,11例死胎史者阳性2例。14例新生儿脐血阳性11例。提示HCMV感染与致畸、自然流产,死胎有密切关系,新生儿可从HCMV-IgM阳性的母亲获得先天性感染。     

Evaluation on Clinical Application of Three Testing Methods for Human Cytomegalovirus Infection in Pregnancy

Summary:The value of ELISA,N-PCR and RT-PCR in clinical practice for pregnant women withHCMV infection was investigated.5581 pregnant women were screened by ELISA.Among them,100 cases were positive for IgM(group 1),69 for both IgM and serous DNA(group 2)and 69 forboth IgM and mRNA(group 3).The infectious status,maternal-fetal transmission and pregnancyoutcome were monitored.It was demonstrated that the accordance rate of group 3 and group 2 withgroup 1 was 56.25％ and 43.75％,respectively.The maternal-fetal transmission rate in the group1,2 and 3 was 19.00％,40.58％ and 46.15％,respectively,with a significant difference foundbetween group 2,3 and group 1(P<0.01).Incidence of spontaneous abortion,fetal death,fetalabnormality and neonatal death in group 1,2 and 3 was 10.00％,15.94％ and 30.77％,respec-tively,and that of group 3,2 was 4 and 2 times as much as that of group 1,respectively(OR=4.00,P<0.001;OR=2.343,P<005,respectively).It was concluded that HCMV-IgM(+)can on-ly be considered as an screening in