孕前检查TORCH感染及与不良妊娠结局相关性分析
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摘要
目的:探讨孕前检查TORCH感染及与死胎死产、自然流产史的相关性。方法:收集2015年1月—2017年1月于本院行孕前检查的育龄女性1705例妇女血液样本,酶联免疫吸附试验检测弓形虫(TOX)、风疹(RV)、巨细胞病毒(CMV)感染情况,追踪妊娠结局,分析TOX、RV、CMV感染与妊娠结局的相关性。结果:本组共检出119例TORCH感染(6.98%),TOX感染24例(1.41%),RV感染42例(2.46%),CMV感染53例(3.11%), 20～30岁组TOX、RV、CMV感染率均高于31～39岁组(P<0.05)。1705例育龄中1620例(95.0%)被随访;其中妊娠1102例(68.0%),发生死胎死产38例(2.3%)、自然流产43例(2.7%),不良妊娠率81例(5.0%);感染组不良妊娠结局发生率高于未感染组(P<0.05),感染TOX IgG(﹢)或IgM(﹢)组死胎死产、自然流产发生率高于TOX IgG(-)或IgM(-)组(P<0.05),RV IgG(﹢)组高于RV IgG(-)组(P<0.05),CMV IgG(﹢)或IgM(﹢)组高于CMV IgG(-)和IgM(-)组(P<0.05)。TOX IgG(﹢)或IgM(﹢)、RV IgG(﹢)、CMV IgG(﹢)或IgM(﹢)均是死胎死产、自然流产的独立危险因素。结论:TORCH感染与死胎死产、自然流产不良妊娠结局密切相关,20～30岁妇女TORCH感染较高,应加强孕前TORCH筛查并积极干预。
Objective: To investigate the TORCH infection of women before pregnancy, and to analyze the correlation of TORCH infection and the rate of stillbirth or spontaneous abortion of women after pregnancy. Methods: Peripheral blood samples from 1705 women who experienced the pre-pregnant examination were collected from January 2015 to January 2017. The infection situations of toxoplasma gondii(TOX), rubella(RV) and cytomegalovirus(CMV) were detected by enzyme-linked immunosorbent assay. The pregnant women were followed-up, and the relationship between the rate of TOX, RV, CMV infection of women and their pregnancy outcomes were analyzed. Results: A total of 119(7.0%) women with TORCH infections in the included 1705 women were diagnosed, and among them, there were 24 women with TOX infection(1.4%), 42 women with RV infection(2.5%), 53 women with CMV infection(3.1%). The infection rates of TOX, RV and CMV of women with 20-30 years old were significant higher than those of women with 31-39 years old(P<0.05). 1620(95.0%) women were followed-up and 1102(68.0%) women were pregnant. In these 1102 pregnant women, there were 38 women(3.45%) with stillborn, 43 women(3.9%) with spontaneous abortion, and 81 women(7.35%) with abnormal pregnancy. The rate of adverse pregnancy outcomes of women with TORCH infection was significant higher than that of women without TORCH infection(P<0.05). The rates of stillborn and stillborn, and spontaneous abortion of women with TOX IgG(﹢),TOX IgM(﹢),RV IgG(﹢),CMV IgG(﹢), or IgM(﹢) were significant higher than those of women with TOX IgG(-),IgM(-),RV IgG(-), CMV IgG(-), or IgM(-)(P<0.05). Women with TOX IgG(﹢),TOX IgM(﹢),RV IgG(﹢),CMV IgG(﹢), or IgM(﹢) were the independent risk factors of stillbirth and spontaneous abortion occurred. Conclusions: TORCH infection is closely related to stillbirth,stillbirth and other adverse pregnancy outcomes,and women with 20-30 years old have higher rate of TORCH infection,so pre-pregnancy TORCH screening should be strengthen.
Objective: To investigate the TORCH infection of women before pregnancy, and to analyze the correlation of TORCH infection and the rate of stillbirth or spontaneous abortion of women after pregnancy. Methods: Peripheral blood samples from 1705 women who experienced the pre-pregnant examination were collected from January 2015 to January 2017. The infection situations of toxoplasma gondii(TOX), rubella(RV) and cytomegalovirus(CMV) were detected by enzyme-linked immunosorbent assay. The pregnant women were followed-up, and the relationship between the rate of TOX, RV, CMV infection of women and their pregnancy outcomes were analyzed. Results: A total of 119(7.0%) women with TORCH infections in the included 1705 women were diagnosed, and among them, there were 24 women with TOX infection(1.4%), 42 women with RV infection(2.5%), 53 women with CMV infection(3.1%). The infection rates of TOX, RV and CMV of women with 20-30 years old were significant higher than those of women with 31-39 years old(P<0.05). 1620(95.0%) women were followed-up and 1102(68.0%) women were pregnant. In these 1102 pregnant women, there were 38 women(3.45%) with stillborn, 43 women(3.9%) with spontaneous abortion, and 81 women(7.35%) with abnormal pregnancy. The rate of adverse pregnancy outcomes of women with TORCH infection was significant higher than that of women without TORCH infection(P<0.05). The rates of stillborn and stillborn, and spontaneous abortion of women with TOX IgG(﹢),TOX IgM(﹢),RV IgG(﹢),CMV IgG(﹢), or IgM(﹢) were significant higher than those of women with TOX IgG(-),IgM(-),RV IgG(-), CMV IgG(-), or IgM(-)(P<0.05). Women with TOX IgG(﹢),TOX IgM(﹢),RV IgG(﹢),CMV IgG(﹢), or IgM(﹢) were the independent risk factors of stillbirth and spontaneous abortion occurred. Conclusions: TORCH infection is closely related to stillbirth,stillbirth and other adverse pregnancy outcomes,and women with 20-30 years old have higher rate of TORCH infection,so pre-pregnancy TORCH screening should be strengthen.
引文
[1] 钟华,欧阳辉,温后烺.TORCH 感染对自然流产患者的影响观察[J].中国医学工程,2016,18(10):60-61.
[2] 彭扬洋,朱功民,范海宁,等.自然流产患者TORCH检验的结果分析[J].现代生物医学进展,2015,15(19):3707-3710.
[3] 张淑杰.优生优育TORCH感染筛查及分析探讨[J].河北医学,2015(8):1538-1539.
[4] 桂俊豪,黄国香,王铮,等.TORCH感染与不良妊娠的大样本回顾分析[J].中国优生与遗传杂志,2006,14(1):69-70.
[5] 符梅,徐克惠.复发性自然流产夫妇的病因分析[J/CD].中华妇幼临床医学杂志(电子版),2016,12(4):395-400.
[6] 黎雄,林恒升,岳晓荷,等.海南省东方市1938例孕妇TORCH-IgM检测结果分析[J].中国热带医学,2016,16(8):848-850.
[7] Duchon,Zachariah.TORCH infections[J].Clinics in Perinatology,2015,42(1).
[8] Tolockiene E,Morsing E,Holst E,et al.Intrauterine infection may be a major cause of stillbirth in Sweden[J].Acta Obstetricia Et Gynecologica Scandinavica,2015,80(6):511-518.
[9] 吴春燕,李泽泳.广州婴幼儿TORCH检测结果及感染病例分析[J].检验医学与临床,2016,13(2):250-252.
[10] 王甲甲,王智斌,黄文芳.TORCH 病原体感染与自然流产的关系及影响因素[J].中国计划生育和妇产科,2015(7):49-52.
[11] 王仙凤,谭晓霞.丽水市孕前检查TORCH感染及与死胎死产、自然流产史的关系[J].中国妇幼保健,2016,31(2):342-344.
[12] 江毅,杨柳山,方恒晓,等.新生儿先天性心脏病与孕期母亲病原体感染的关系研究[J].中国妇幼保健,2015,30(33):5792-5793.
[13] 王晓明,张国成,韩美玉,等.先天性心脏病心脏组织中TORCH 病原基因的检测[J].中华实验和临床病毒学杂志,2001,15(2):176-178.
[14] 张世勇,王洋,陶永梅,等.育龄妇女弓形虫、风疹病毒和巨细胞病毒感染现状及其与不良妊娠结局的相关性研究[J].检验医学与临床,2015,12(5):594-596,599.
[15] 谢华秀.孕妇TORCH感染与不良孕产史的相关性分析[J].中国优生与遗传杂志,2017,25(1):89-90.
[2] 彭扬洋,朱功民,范海宁,等.自然流产患者TORCH检验的结果分析[J].现代生物医学进展,2015,15(19):3707-3710.
[3] 张淑杰.优生优育TORCH感染筛查及分析探讨[J].河北医学,2015(8):1538-1539.
[4] 桂俊豪,黄国香,王铮,等.TORCH感染与不良妊娠的大样本回顾分析[J].中国优生与遗传杂志,2006,14(1):69-70.
[5] 符梅,徐克惠.复发性自然流产夫妇的病因分析[J/CD].中华妇幼临床医学杂志(电子版),2016,12(4):395-400.
[6] 黎雄,林恒升,岳晓荷,等.海南省东方市1938例孕妇TORCH-IgM检测结果分析[J].中国热带医学,2016,16(8):848-850.
[7] Duchon,Zachariah.TORCH infections[J].Clinics in Perinatology,2015,42(1).
[8] Tolockiene E,Morsing E,Holst E,et al.Intrauterine infection may be a major cause of stillbirth in Sweden[J].Acta Obstetricia Et Gynecologica Scandinavica,2015,80(6):511-518.
[9] 吴春燕,李泽泳.广州婴幼儿TORCH检测结果及感染病例分析[J].检验医学与临床,2016,13(2):250-252.
[10] 王甲甲,王智斌,黄文芳.TORCH 病原体感染与自然流产的关系及影响因素[J].中国计划生育和妇产科,2015(7):49-52.
[11] 王仙凤,谭晓霞.丽水市孕前检查TORCH感染及与死胎死产、自然流产史的关系[J].中国妇幼保健,2016,31(2):342-344.
[12] 江毅,杨柳山,方恒晓,等.新生儿先天性心脏病与孕期母亲病原体感染的关系研究[J].中国妇幼保健,2015,30(33):5792-5793.
[13] 王晓明,张国成,韩美玉,等.先天性心脏病心脏组织中TORCH 病原基因的检测[J].中华实验和临床病毒学杂志,2001,15(2):176-178.
[14] 张世勇,王洋,陶永梅,等.育龄妇女弓形虫、风疹病毒和巨细胞病毒感染现状及其与不良妊娠结局的相关性研究[J].检验医学与临床,2015,12(5):594-596,599.
[15] 谢华秀.孕妇TORCH感染与不良孕产史的相关性分析[J].中国优生与遗传杂志,2017,25(1):89-90.