应用套式聚合酶链反应技术检测孕妇与胎儿巨细胞病毒感染

目的评价套式聚合酶链反应技术（ＮＴ－ＰＣＲ）加限制酶分析在孕妇与胎儿人巨细胞病毒（ＨＣＭＶ）感染检测中的应用价值。方法应用ＮＴ－ＰＣＲ及限制酶分析、病毒分离、电镜观察和特异性抗体测定,对各孕期孕妇３６７例的外周血、部分孕妇脐血及死胎组织进行ＨＣＭＶ检测。结果孕早、中、晚期ＨＣＭＶ阳性检出率分别为８．６％、１．６％及７．０％,ＮＴ－ＰＣＲ检出率（４．９％）高于病毒分离（３．０％,Ｐ＜０．０２５）。６份ＨＣＭＶＤＮＡ阳性母血中,３份配对脐血ＨＣＭＶＤＮＡ也阳性。其中２对ＮＴ－ＰＣＲ、病毒分离及特异性ＩｇＭ、ＩｇＡ均阳性,１对ＮＴ－ＰＣＲ、病毒分离、特异性ＩｇＡ阳性,而ＩｇＭ阴性。２８例死胎组织中,发现１例死胎肺组织ＨＣＭＶＤＮＡ阳性。结论ＮＴ－ＰＣＲ能提高诊断ＨＣＭＶ感染的特异性与敏感性

Detection of human cytomegalovirus infection in pregnant women and their fetuses by nested polymerase chain reaction

Objectives To evaluate the applicability of nested polymerase chain reaction (PCR) and restriction endonucleases analyses (REA) for the diagnosis of human cytomegalovirus (HCMV) in pregnant women and their fetuses. Methods Nested PCR and REA, virus isolation, anti HCMV IgM and anti HCMV IgA were used for detection of HCMV in peripheral blood of pregnant women, umbilical blood and tissues of stillbirths. Results among 367 pregnant women, the HCMV infections rate in the first, second and third trimester of gestation were 8.6%, 1.6% and 7.0%, respectively. The nested PCR had significantly higher detective rate (4.9%) than that of virus isolation (3.0%, P <0.025). Among 6 samples of maternal HCMV DNA positive blood, 3 matched umbilical samples were HCMV DNA positive as well. Of these 3 cases, HCMV intrauterine infection was considered. HCMV was detected with all measurements in both maternal and umbilical blood except in 1 paired samples specific IgM were negative. HCMV DNA was found in the lung tissue of one of the 28 stillbirths. Conclusion the diagnostic specificity and sensitivity of HCMV can be raised by nested PCR.