套式聚合酶链反应加限制酶分析检测母婴巨细胞病毒感染

为评价套式聚合酶链反应（套式ＰＣＲ）加限制酶分析在孕妇巨细胞病毒感染及其母婴宫内传播检测中的应用，采用套式ＰＣＲ加限制酶分析，病毒分离、电镜观察和特异性抗体测定，对各孕期孕妇外周血，脐血及死胎组织进行人巨细胞病毒（ＨＣＭＶ）检测。结果：３６７名孕妇ＨＣＭＶ阳性检出率为５．５％，其中，套式ＰＣＲ检出率（４．９％）高于病毒分离（３．０％，Ｐ＜０．０５）。６份ＨＣＭＶＤＮＡ阳性母血中，３份配对脐血ＨＣＭＶＤＮＡ也阳性，母－脐传播率为３／６。３对被证实为母－婴宫内传播ＨＣＭＶ的标本中，２对套式ＰＣＲ，病毒分离及特异性ＩｇＭ、ＩｇＡ均阳性，１对套式ＰＣＲ、病毒分离、特异性ＩｇＡ阳性，ＩｇＭ阴性。提示：套式ＰＣＲ能提高诊断ＨＣＭＶ的特异性与敏感性，对孕妇及胎儿／新生儿ＨＣＭＶ感染的研究有重要意义。

A study on human cytomegalovirus infection in pregnant women and their babies by nested polymerase chain reaction and restriction endonucleases analyses

To evaluate the applicability of nested polymerase chain reaction (PCR) and restriction endonucleases analyses (REA) in the diagnosis of human cytomegalovirus (HCMV) infection in pregnant women and to find possible causes resulting in the maternal fetal transmission of HCMV, the authors applied nested PCR and REA, virus isolation, electron microscopy, tests for anti HCMV IgM and anti HCMV IgA detection on peripheral venous blood of gravida, umbilical blood of fetuses and tissues of stillbirths. The results showed that among 367 pregnant women, the rates of infection with HCMV during the first, second and third trimesters of gestation were 8.6%, 1.6% and 7.0%, respectively. The positivity rate of nested PCR was 4.9%, which was significantly higher than that of virus isolation (3.0%, P <0.05). Among 6 HCMV DNA positive maternal blood samples, 3 matched umbilical blood samples were also HCMV DNA positive. The rate of maternal fetal transmission was 50% (3/6). Of the 3 paired blood samples suggesting intrauterine HCMV infection, 2 pairs were confirmed to be infected with HCMV by the nested PCR, virus isolation, specific IgM and IgA detection, one pair was confirmed by the nested PCR, virus isolation, specific IgA antibody. HCMV DNA was found in the lung tissue of one of 28 stillbirth fetuses. These results suggest that the specificity and sensitivity of diagnosis of HCMV infection could be raised by nested PCR, which has an important significance in the clinical diagnosis of HCMV ifnection in pregnant women and fetuses/neonates.