人巨细胞病毒感染与先天性畸形关系的探讨

探讨人巨细胞病毒宫内感染与先天性畸形的关系,并确定巨细胞病毒感染组织细胞细胞。方法利用聚合酶链反应技术,对近８年来我院尸检畸形儿４１例同期尸检非畸形儿１９例进行了主要脏器的ＨＣＭＶ检测,对部分ＰＣＲ阳性的组织本,用原位杂交技术确定ＨＣＭＶ易感组织细胞类型。

Human cytomegalovirus infection and congenital malformation

Objective To study the relationship between intrauterine cytomegalovirus (HCMV) infection and congenital malformation, and to determine the distribution of tissues infected. Methods Autopsy samples of 41 infants with congenital malformation and 19 infants with normal appearances were studied. Using polymerase chain reaction (PCR) technique the paraffin embedded specimens of main organs were examined for HCMV infection. In situ hybridization (ISH) was performed in some of the PCR positive tissues in order to define the distribution of HCMV DNA. Results 19 of the 41 infants (46.34%) with congenital defects were HCMV positive, while 1 in 19 (5.26%) were positive in the control group, and there was significant difference between the 2 groups ( P <0.05). 20.46% (35/171) of the fetal organ samples were HCMV DNA positive in the malformation group, but only 1 out of 78 samples (1.28%) was positive in the pulmonary tissue of the control group. More malformations of the digestive system were presented in HCMV infected babies but no statistical significant difference when compared with other systems. Brain tissue had the highest HCMV infection rates (41.37%, 12/29), which was significantly higher than other organs. By ISH technique HCMV DNA was found only in 6 out of 17 PCR positive samples, and they were located at neurons, neurogliocytes, epithelium and interstitial cells of the kidney, and epithelial cells of pulmonary alveolar. Conclusion There are strong correlation between HCMV infection and congenital malformation, and brain is more susceptible to HCMV. By combining PCR and ISH, both sensitivity and distribution of HCMV could be obtained.