摘要
目的 探讨孕期干预减少人巨细胞病毒 (HCMV)和弓形虫 (TO)宫内感染所致出生缺陷的效果。方法 采用前瞻性随机对照临床研究方法 ,检测 3 0 95例有异常孕产史的孕妇外周血中的 HCMV和 TO特异性抗体 Ig G和 Ig M,对 HCMV Ig M阳性者再检测 HCMV晚期 m RNA。对 119例 HCMV Ig M和 HCMV m RNA均阳性者服用中药金叶败毒颗粒 ,12 9例作为对照 ;给 13 1例 TO Ig M阳性者服用西药螺旋霉素 ,13 9例作为对照。结果 中药金叶败毒颗粒可使孕妇 HCMV Ig M和 HCMV m RNA转阴率从自然状态下的 42 .64 % (5 5 / 12 9)提高到 71.43 % (85 / 119) (χ2=2 0 .87,P=0 .0 0 1) ,宫内传播率从自然状态下的 47.5 0 % (19/ 40 )下降到 2 0 .0 0 % (15 / 75 ) (χ2 =9.47,P=0 .0 0 1) ,并大大减少了流产、死胎、先天畸形等子代生长发育异常。西药螺旋霉素可使孕妇 TO Ig M转阴率从 3 5 .2 5 % (49/13 9)提高到 72 .5 2 % (95 / 13 1) (χ2 =3 7.63 ,P=0 .0 0 1) ,宫内传播率从自然状态下的 2 4.2 4% (8/ 3 3 )下降到 7.3 5 %(5 / 68) (χ2 =5 .65 ,P=0 .0 0 2 )。结论 筛选孕期 HCMV Ig M和 HCMV m RNA阳性以及 TO Ig M阳性的妇女 。
Objective: To study the prevention effect of interfering in pregnancy on reducing birth deficiency induced by human cytomegalovirus (HCMV) and toxoplasma (TO) intrauterine infection. Methods: With prospectively randomized controlled trials, 3 095 cases of pregnant women who had abnormal pregnancy history were investigated. Using enzyme linked immunoabsorbent assay (ELISA), the specific antibody IgG and IgM of HCMC and TO in the patients' plasma were detected. Then using reverse transcription polymerase chain reaction (RT PCR) to detect HCMV mRNA in the IgM positive expression. 119 cases of HCMV active infection women with HCMV IgM and mRNA positive expression took Jinyebaidu granule, whereas 129 cases of the control did not have any medicine. 131 cases of TO active infection women with TO IgM positive expression took spiramycin, whereas 139 cases of the control did not take any medicine. Results: Jinyebaidu granule can raise significantly the trans negative rate of HCMV IgM and HCMV mRNA from 42.64% (55/129) to 71.43% (85/119) ( χ 2=20.87, P =0.001). The intrauterine infection rate reduced from 47.50% (19/40) to 20.00% (15/75) ( χ 2=9.47, P =0.001). And abortion, death fetus and congenital abnormity have been reduced greatly. Spiramycin can raise significantly the trans negative rate of TO IgM from 35.25% (49/139) to 72.52% (95/131) ( χ 2=37.63, P =0.001). The intrauterine infection rate reduced from 24.24% (8/33) to 7.35% (5/68) ( χ 2=5.65, P =0.002). Conclusion: Giving Jinyebaidu granule and spiramycin respectively to pregnant women with positive HCMV IgM and TO IgM can prevent birth deficiency induced by intrauterine infection.
出处
《中国妇幼保健》
CAS
2003年第2期100-102,共3页
Maternal and Child Health Care of China
基金
国家"九五"科技攻关项目(项目编号 :96- 90 4 - 0 6- 0 8)
关键词
孕期
干预
宫内感染
出生缺陷
临床意义
Human cytomegalovirus (HCMV)
Toxoplasma (TO)
Intrauterine infection
Prevention
