活动性巨细胞病毒感染与反复自然流产的关系探讨

目的探讨活动性人巨细胞病毒（human cytomegalovirus,HCMV）感染与反复自然流产（recurrent spontaneous abortion,RSA）的关系.方法采集反复自然流产孕妇和正常产前体检孕妇外周血,分离外周血单个核细胞（PBMCs）和血浆,分别用免疫荧光法和实时定量PCR检测HCMV pp65抗原和HCMV DNA,并比较2种方法的一致性.结果 65例RSA患者HCMV pp65抗原有20例阳性,阳性率30.8%,50例正常体检孕妇 HCMV pp65抗原有4例阳性,阳性率8.0%,2组孕妇HCMV活动性感染率有显著性差异（χ^2=8.87,P＜0.01）.孕妇HCMV pp65抗原阳性率升高,孕妇流产几率增加（χ^2=7.53,P＜0.01）. 免疫荧光法和实时定量PCR有较好的一致性（92.3%）.结论反复自然流产孕妇 HCMV活动性感染率显著高于正常孕妇,HCMV pp65抗原检测也许可作为RSA早期诊断指标之一.

The relationship between active human cytomegalovirus infection and recurrent spontaneous abortion

Objective: To investigate the relationship between recurrent spontaneous abortion(RSA)and active human cytomegalovirus(HCMV)infection.Methods: 65 blood specimens from the pregnancy woman with RSA and 50 blood specimens from the normal pregnancy woman were collected.The peripheral blood mononuclear cells(PBMCs) were separated from plasma,and the former was used for the HCMV pp65 antigen test by immune fluorescent assay(IFA) and HCMV DNA was quantitaive analysis by real-time quantitative polymerase chain reaction(PCR)in parallel comparison with the HCMV pp65 antigen test.Results: 30.8%pregnancy woman with RSA were positive to HCMV pp65 antigen and 8.0% normal pregnancy woman were positive.The correspondence of the HCMV pp65 test and quantitative PCR was 92.3%.Conclusion: The rate of active HCMV infection in pregnancy woman with RSA markedly high than that of normal pregnancy woman,it suggested that HCMV pp65 perhaps be one of diagnosis mark of RSA.