285例妊娠妇女生殖道感染调查分析

目的了解妊娠妇女生殖道感染情况,以便采取有效措施确保母婴健康.方法对就诊的妊娠妇女分别从阴道后穹窿及宫颈取标本作支原体、加德纳杆菌、念珠菌、衣原体、滴虫、淋球菌等检查.结果经相应的方法检查,共检查到支原体147例,占51.58%,加德纳杆菌139例,占48.77%,念珠菌123例,占43.16%,衣原体34例,占11.93%,滴虫32例,占11.23%,淋球菌23例,占8.07%;其中有2种病原体混合感染的有151例,3种病原体混合感染的有62例;另外,配偶间有婚外性行为的检出率明显高于无婚外性行为者;年龄越低的妊娠妇女阴道清洁度越差.结论支原体、加德纳杆菌、念珠菌等仍是妊娠妇女生殖道较为常见的病原菌,尤以在低年龄、配偶间有婚外性行为者检出率更高;临床上应加强对孕妇进行性传播病原体检查,以确保母婴健康.     

保定地区孕妇弓形虫感染流行病学调查

弓形虫病是由刚地弓形虫所引起的人畜共患传染性疾病，也是妇女围产期一种重要的寄生虫病，孕妇由于妊娠的生理变化，免疫力下降，易因感染弓形虫而出现流产、早产或增加妊娠合并症，同时还可透过胎盘屏障影响胎儿的宫内发育，甚至造成各种出生缺陷或死亡。由于人对弓形虫普遍易感，因此该病广泛流行于世界各地。但不同国家和地区其感染发生的情况有着很大差异，世界各地感染率平均在25％～58％左右 。     

绍兴地区妊娠早期妇女TORCH感染调查分析

目的探讨绍兴地区妊娠早期妇女TORCH(Toxoplasma、Rubella Virus、Cytomegalovirus,CMV、HerpesimpiexVirus)的感染状况及其临床意义,为早期诊断和防治提供依据。方法采用抗体酶联免疫吸附试验法(ELISA法)检测11006例妊娠早期妇女血清中TORCH特异性抗体(IgM)阳性率。结果 HSV-IgM、CMV-IgM、TOX-IgM、RV-IgM的阳性感染率分别为1.42%、0.89%、0.50%、1.12%;两组妊娠结局:实验组自然流产、死胎、胎儿畸形、新生儿畸形等发生率明显高于对照组(P<0.005)。结论妊娠早期妇女TORCH检测可有效预防宫内感染及畸形胎儿出生,以提高优生优育质量。     

孝感地区农村育龄妇女弓形虫感染情况初步调查

弓形虫病是动物源性疾病，许多哺乳动物和多种鸟类是人类的传染源。本计６０５便本地农村育龄妇女进行弓形虫感染初步调查，结果孝感农村育龄妇女弓形虫感染总阳性率２４．１３％；弓形虫感染是致宫内死胎的重要原因之一。     

妊娠与非妊娠妇女生殖道肺炎支原体感染的研究

目的：了解我国妊娠与非妊娠妇女生殖道肺炎支原体（Mpn)感染状况。方法：应用套式聚合酶链式反应（nPCR)、选择性培养和全自动DNA序列测定技术对100例妊娠妇女和100例非妊娠妇女的阴道拭子标本进行检测。结果：Mpn nPCR检测妊娠妇女阴性率为6％,非妊娠妇女为3％。Mpn nPCR呈阳性的标本经选择性培养均分离到Mpn。1例Mpn nPCR阳性产物经全自动DNA序列测定与Mpn标准株序列完全一致。结论：我国妊娠与非妊娠妇女生殖道均存在Mpn感染。     

常熟地区孕妇弓形虫感染与妊娠结局的初步观察

对常熟地区１０６４０例孕妇用ＥＬＩＳＡ法进行弓一菜虫感染血甭学检查，检出弓形虫抗体阳性８５０例，感染率为７．５７％，并对９４０例孕妇进行妊娠结局随访观察，其中８７０例弓形虫抗体阴性，妊娠结局均良好；７０例阳性孕妇中，有１４例出现异常妊娠结局，本文亦认为孕妇弓形虫感染与妊娠结局异常有关。采用螺旋霉素治疗效果满意。     

北京地区妊娠妇女中单纯疱疹病毒感染的研究

近年来 ,由单纯疱疹病毒 (ＨＳＶ)引起的人类生殖道感染有明显升高的趋势[1] ,孕妇感染ＨＳＶ后可引起胎儿宫内感染 ,导致流产、死产及新生儿感染等一系列不良后果[2 ] 。按照血清学分型 ,ＨＳＶ可分为ＨＳＶ Ⅰ型和ＨＳＶ Ⅱ型两大类[3] 。一般认为ＨＳＶ Ⅱ与生殖道感染的关系比较密切 ,而ＨＳＶ Ⅰ型则与其他感染有关。但一些调查也发现了ＨＳＶ Ⅰ引起的孕妇感染和宫内感染[4 ,5] 。为了研究ＨＳＶ可能引起的宫内感染问题 ,我们利用酶联免疫吸附实验 (ＥＬＩＳＡ)技术对 2 82例北京地区孕妇血中的ＨＳＶ Ⅰ型和ＨＳＶ Ⅱ型的ＩｇＭ抗体…     

孕妇早期感染弓形虫对妊娠的影响调查分析

目的探讨孕妇孕早期弓形虫感染对妊娠结局以及新生儿的影响,为产前预防弓形虫感染新生儿出生提供实践依据。方法对我院就诊弓形虫抗体IgM阳性发现孕妇进行回顾性分析,比较与为感染孕妇间妊娠结局的差别。结果孕早期弓形虫抗体IgM阳性对孕产妇妊娠结局及新生儿影响均具有统计学意义（P〈0.05）。结论孕前及孕早期对弓形虫抗体的筛查,必要时终止妊娠,对于优生优育具有很好的指导意义。     

昆山市献血员弓形虫感染调查

弓形虫病(toxoplasmosis)又称弓形体病,是由弓形虫所引起的一种人兽共患性疾病,广泛流行于世界各地。据报道,弓形虫感染在我国亦普遍存在,其传播途径除饮食、水源污染、接触感染禽畜外,亦可通过输血感染。但国内有关献血员弓形虫感染的报道较少,为了解献血员的感染情况,我们对本市800名献血员作了弓形虫抗原、抗体检测,现将结果报告如下。 材料和方法 1997年5～7月,我们对本市800名(男女)献血员作了弓形虫感染的调查,男性年龄在20～55岁,女性20～50岁之间,均有一次以上的献血史,常规体检及实验室检查均无异常,大部分献血员家中饲养猫、鸡、狗等家禽、家畜。每个献血员均于肘静脉抽血3ml,及时分离血清,冷冻保存备检。弓形虫试剂盒由上海放射免疫分析技术研究所提供,由专人按说明书操作。 结果 800名献血员检测结果,发现循环抗原阳性3人,IgM及IgA抗体阳性3人,IgG抗体阳性21人,共有27人感染,阳性率为3.4％,其中女性17人,男性10人,全系农民,均有家禽家畜接触史。     

弓形虫感染对孕妇妊娠结局的影响

目的 :探讨感染弓形虫对孕妇妊娠结局的影响。方法 :采用孕妇外周血及新生儿脐血进行弓形虫抗体IgM检测 ,比较正常孕产组与异常孕产组感染弓形虫抗体IgM阳性率之差异 ,比较孕妇IgM阳性组与IgM阴性组的不同妊娠结局分布。结果 :孕妇外周血及新生儿脐血的正常孕产组与异常孕产组弓形虫IgM抗体阳性率具有显著差异 ,P <0 .0 5 ;弓形虫IgM阳性组孕妇出现低体重儿、早产显著高于阴性组孕妇 ,P <0 .0 5 ,IgM阳性组孕妇出现的畸形儿及不良结局小计显著高于阴性组孕妇 ,P <0 .0 1。结论 :提示孕妇感染弓形虫与异常生育密切相关     

Seroprevalence and Risk Factors for Toxoplasma gondii Infection among Pregnant Women in Northeast Iran

We report Toxoplasma IgG seroprevalence of 34.4% among 419 pregnant women in Mashhad, northeast Iran. Soil contact, living in rural environment, and level of education were associated with infection. The prevalence did not increase with age, suggesting high infection rate during childhood and adolescence.     

妊娠期妇女甲状腺功能检查结果分析

目的 通过研究妊娠期妇女血清中甲状腺指标的变化情况,探讨甲功检测在妊娠妇女中的应用价值.方法 应用化学发光分析仪对747例早中期妊娠妇女(实验组)和593例非妊娠育龄妇女(对照组)血清中的甲功五项(血清三碘甲状腺原氨酸(triiodothyronine,T3)、甲状腺素(thyroxin,T4)、血清促甲状腺素(thyrotropin,TSH)、游离三碘甲状腺氨酸(freetriiodothyronine,FT3)以及游离甲状腺素(free thyroxine,FT4))进行检测,比较两组结果的差异,同时分析TSH与人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)结果的相关性.结果 ①747份妊娠期妇女血清,甲状腺功能检查指标有异常的254份,异常率为34.09％,593份对照组血清,指标异常98份,异常率16.53％,异常率差异有统计学意义(P＜0.05);②妊娠期妇女TSH水平低于对照组,TT3和TT4高于对照组,差异有统计学意义(P＜0.05),而FT3、FT4两组差异无统计学意义(P＞0.05);③TSH水平与同期HCG水平呈负相关,r=-0.527(P ＜0.05),同时TSH异常低值组HCG水平(16.22×104 ±4.34×104 mIU/mL)明显高于TSH正常组(7.83×104±5.30×104mIU/mL),差异有统计学意义(P＜0.05).结论 妊娠期妇女甲状腺功能异常率升高明显,应加强其甲状腺功能的监测,同时注意高浓度HCG对TSH检测结果的影响.     

Incidence of Toxoplasma gondii Infection in 35,940 Pregnant Women in Norway and Pregnancy Outcome for Infected Women

From 1992 to 1994 a screening program for detection of specific Toxoplasma gondii antibodies involving 35,940 pregnant women was conducted in Norway. For women with serological evidence of primary T. gondii infection, amniocentesis and antiparasitic treatment were offered. The amniotic fluid was examined for T. gondii by PCR and mouse inoculation to detect fetal infection. Infants of infected mothers had clinical and serological follow-up for at least 1 year to detect congenital infection. Of the women 10.9% were infected before the onset of pregnancy. Forty-seven women (0.17% among previously noninfected women) showed evidence of primary infection during pregnancy. The highest incidence was detected (i) among foreign women (0.60%), (ii) in the capital city of Oslo (0.46%), and (iii) in the first trimester (0.29%). Congenital infection was detected in 11 infants, giving a transmission rate of 23% overall, 13% in the first trimester, 29% in the second, and 50% in the third. During the 1-year follow-up period only one infant, born to an untreated mother, was found to be clinically affected (unilateral chorioretinitis and loss of vision). At the beginning of pregnancy 0.6% of the previously uninfected women were falsely identified as positive by the Platelia Toxo-IgM test, the percentage increasing to 1.3% at the end of pregnancy. Of the women infected prior to pregnancy 6.8% had persisting specific immunoglobulin M (IgM). A positive specific-IgM result had a low predictive value for identifying primary T. gondii infection.     

遂宁地区孕妇TORCH检测分析

目的了解我院TORCH的感染率,为临床指导优生优育提供更多的参考依据。方法采用捕获ELISA法对样本进行检测。结果TORCH特异性IGM抗体的总阳性率为0.82%,其中TOX未查见阳性,RV占0.11%,CMV占0.35%,HSV占0.35%。发病季节,RV主要在冬季,CMV主要在秋冬两季,HSV发病季节主要在春秋冬季。结论尽管遂宁地区TORCH的感染率较低,但严格执行预防和控制TORCH系列病原体感染仍是优生优育的一项重要措施。     

Development of Specific Immunoglobulins G, M, and A Following Primary Toxoplasma gondii Infection in Pregnant Women

The development of specific antibodies following primary Toxoplasma gondii infection during pregnancy was assessed by six different antibody assays: dye test, Platelia Toxo-IgG, Toxo-Screen DA IgG, Platelia Toxo-IgM, Toxo-ISAGA IgM, and Platelia Toxo-IgA. A total of 126 sera from 27 pregnant women, for whom the time of acquisition of infection could be estimated fairly accurately, were included. All tests showed great individual variation in the peak amounts of antibodies detected. The times elapsed after infection until the peak was reached also varied greatly from individual to individual: the ranges were 2 to 21 weeks for the dye test, 4 to 36 weeks for Platelia Toxo-IgG, 4 to 30 weeks for Toxo-Screen DA IgG, 2 to 18 weeks for Platelia Toxo-IgM, 1 to 6 weeks for Toxo-ISAGA IgM, and 2 to 21 weeks for Platelia Toxo-IgA. In the early phase of the infection the dye test and the specific-IgM tests were the most sensitive. Toxo-Screen DA IgG was more sensitive than Platelia Toxo-IgG in the acute phase, while Platelia Toxo-IgA was clearly the least sensitive assay. Of the sera collected 21 to 52 weeks after infection, all were positive by the dye test, all except one (which was negative by Platelia Toxo-IgG) were positive by the specific-IgG tests, approximately 80% were positive by the IgM tests, and 45% were positive by the IgA test. Due to the great individual variation it seems impossible to estimate when the infection occurred based on results obtained from a single serum, and it may even be difficult to assess when a titer increase in paired sera is detectable unless the first sample is only marginally positive. As a diagnostic criterion a dye test titer of ≥300 IU/ml has a low sensitivity for recent primary infection.     

Experimental Feline Herpesvirus Infection in the Pregnant Cat

Intravenous inoculation of pregnant cats with feline herpesvirus produced minimal illness but resulted in abortion, intrauterine fetal death and congenital fetal infection. Placental lesions included multiple infarcts in the placental labyrinth, thrombosis of maternal vessels in the endometrium and placenta, and multifocal necrosis of the giant-cell trophoblast and endometrial epithelium in the junctional zone of the placenta associated with eosinophilic intranuclear inclusion bodies. The virus was isolated from all the placentas and uteri but from none of the fetuses aborted 6-9 days after maternal intravenous inoculation. Viral antigen was demonstrated in the uterine vessels and in the junctional zone of the placenta at this time. On postinoculation day 26, viral antigen was demonstrated in the chorioallantoic membrane on the fetal side of the placenta and in the liver of a congenitally infected fetus. Although all 4 pregnant cats inoculated intranasally with feline herpesvirus aborted, neither virus, viral antigen nor significant lesions were detected in the uteri, placentas or fetuses. Abortion after intranasal inoculation was interpreted as a nonspecific reaction secondary to the severe, debilitating upper respiratory disease that occurred.     

Spiramycin Treatment of Toxoplasma gondii Infection in Pregnant Women Impairs the Production and the Avidity Maturation of T. gondii-Specific Immunoglobulin G Antibodies

The aim of the study was to evaluate the influence of treatment with spiramycin on the increase of immunoglobulin G (IgG) titers and IgG avidity indexes (AI) in pregnant women with seroconversion from the beginning of therapy until delivery and after delivery. This group was compared with adult patients with recently acquired untreated toxoplasmosis. One hundred four samples from 32 pregnant women with seroconversion for toxoplasmosis and/or very low IgG AI were followed from the beginning of therapy with spiramycin until delivery. Twenty-nine women were further followed some months after delivery and interruption of therapy. Thirty-eight samples from 16 untreated, nonpregnant patients were evaluated as the control group. The Toxoplasma gondii-specific IgG antibody and the T. gondii-specific IgG AI were significantly delayed in pregnant women receiving therapy compared to nonpregnant, untreated controls, and the findings were consistent with the results of assays from two different manufacturers. The T. gondii-specific IgG AI increased in pregnant women after they gave birth. Avidity maturation is delayed during pregnancy and treatment, and low-avidity antibodies in pregnant women within 3 to 4 months cannot be taken as a sign of infection.After infection, the specific immunoglobulin G (IgG) antibody response matures by the selection of clones of B cells producing antibodies with increasingly higher avidities against a specific antigen from the invading microorganism. In Toxoplasma gondii infections, specific IgM may be present for a long time (14-17), and measurement of the T. gondii-specific IgG avidity index (AI) is the best method to determine the time of infection (24) and is a further development of the differential agglutination assay (3, 27).The original method developed by Hedman et al. (4, 5) used serial dilutions tested in enzyme immunoassays with and without 6 M urea, but automated assays calculate the IgG AI from two single measurements with and without urea (22). This introduces uncertainty, although experiments with only two serum sample dilutions showed excellent agreement with IgG AI measurements obtained with four serial serum sample dilutions (9).A persistent, low IgG AI poses a diagnostic problem, at least in some pregnant women receiving treatment during pregnancy (21).The observation that Toxoplasma gondii-specific IgG maturation is delayed in treated pregnant women compared to nontreated, nonpregnant individuals has been reported in two previous studies, which found significantly delayed IgG maturation in treated individuals (13, 26).The maturation of the IgG response varies between individuals and may take months in pregnant, treated women, for whom one study found that a low IgG AI persisted up to 9 months postinfection (20). In a study of T. gondii-infected pregnant women identified prospectively through prenatal screening, one study found that 2 out of 73 women had IgG AI above 0.2 before 20 weeks of gestation, but many continued to have low IgG AI even a year after infection. It is assumed that all women were treated during pregnancy (7).One problem with different findings in different studies is the lack of standardization of the T. gondii-specific IgG AI assay (12).We report here that treatment of T. gondii infection may influence IgG production and avidity maturation in pregnant women, which was evaluated by two commercial methods.     

2005年湛江市、韶关市、汕头市人兽弓形虫感染状况调查

目的了解广东省湛江市、韶关市、汕头市的人兽弓形虫感染情况。方法收集3个地区人、猪、鼠血清，采用酶联免疫吸附试验（ELISA）间接法检测弓形虫IgG抗体。结果湛江市检测猪血清279份，阳性13份，阳性率为4．66％，检测鼠血清93份，阳性7份，阳性率7．53％；韶关市检测人血清42份，阳性0份，检测鼠血清95份，阳性3份，阳性率3．16％；汕头市检测人血清50份，阳性6份，阳性率为12．00％，检测鼠血清100份，阳性3份，阳性率为4．00％。结论汕头市人群存在弓形虫感染，湛江市、韶关市、汕头市兽类存在弓形虫感染，3个地区的鼠类弓形虫感染率无统计学意义，家鼠、野鼠的弓形虫感染率也无统计学意义。     

A Standardized Enzyme-Linked Immunosorbent Assay (ELISA) for the Detection of Antibodies to Toxoplasma Gondii

An enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of Toxoplasma gondii infections on single serum dilutions was developed.

This test system is a standardized kit designed to detect circulating specific antibodies to Toxoplasma gondii in human sera. It consists of Toxoplasma gondii soluble antigen-coated microtitration multiwell plates, specific immunoglobulin-enzyme conjugate and other required reagents.

In a clinical trial performed on sera from 1,035 clinically suspected toxoplasmosis cases, the Sabin Feldman Dye Test (SFDT) and this ELISA system agreed closely. Relative to the SFDT, the sensitivity and specificity of the latter was 98.0% and 97.6% respectively with a correlation coefficient of 0.97. In a further study of 121 sera, the Indirect Fluorescent Antibody Test (IFAT), the Indirect Haemagglutination Test (IHAT) and this ELISA procedure showed over 90% agreement, with correlation coefficients of 0.98 and 0.95 respectively. Within the working concentration of specific antibody to T. gondii in human serum, there was a linear relationship between the ELISA values and the WHO international standard for human anti-Toxoplasma serum.