重庆市 4484 例孕前检查妇女 TORCH 感染现状分析
摘要: 目的了解重庆市孕前检查妇女TORCH感染状况及流行特点，为本地区妇女孕前保健提供依据，加强一级预防，减少不良妊娠结局的发生率.方法选择2013年1月-2016年12月共4 484例重庆市渝中区符合国家免费孕前检查的妇女作为研究对象，采用酶联免疫吸附试验(ELISA)检测巨细胞病毒、风疹病毒、弓形虫的IgM和IgG，并分析总体感染状况、不同年龄组感染状况、季节差异及不同年份的感染状况.结果巨细胞病毒(CMV)、风疹病毒(RV)、弓形虫(TOX)的IgG阳性率依次为90.1%，92.7%，4.68%；IgM阳性率依次为0.49%，0.65%，0.02%.不同季节相比，秋季更容易发生CMV和RV急性感染，与其他3季相比，差异具有统计学意义. TOX-IgG抗体在春季检测值明显高于其他3季.不同年龄组相比，CMV，RV的特异性IgM抗体和IgG抗体均无明显差异；20~24岁组和≥35岁组的TOX-IgG抗体分别为7.23%，6.41%，较25~29岁组和30~34岁组的4.28%和4.7%相比，差异具有统计学意义.不同年份相比，2013年CMV，RV，TOX的IgM抗体最高，随之逐年降低，IgG抗体逐年增高.结论重庆市育龄期妇女存在一定比例的CMV，RV，TOX感染，建议备孕妇女行孕前检查时，筛查CMV，RV，TOX，有利于指导其合适的妊娠时间.受孕时间尽量避开秋季，减少因TORCH感染导致的不良妊娠结局.国家启动免费孕前检查以来，TORCH感染逐年下降，表明健康宣教能有效减少TORCH感染.
Analysis of 4 484 Cases of TORCH Infection Among Pre-Pregnant Women in Chongqing
Abstract: ObjectiveThe prevalence and epidemic characteristics of TORCH infection among pre-pregnant women in Chongqing were investigated, which should be able to provide the basis for women's pre-pregnancy health care so as to strengthen primary prevention and reduce the incidence of adverse pregnancy outcomes.MethodsFrom January 2013 to December 2016, 4 484 women in line with the National Free Pre-pregnancy Examination Project in Yuzhong District of Chongqing were selected as the research objects, enzyme-linked immunosorbent assay (ELISA) was used to detect IgM and IgG antibodies to human cytomegalovirus (CMV), rubella virus (RV) and Toxoplasma (Toxo). The overall infection status and infection status in different age groups, seasons and years were analyzed.ResultsThe prevelance serum of IgG antibodies against CMV, RV and TOX was 90.1%, 92.7% and 4.68% and that of IgM antibodies was 0.49%, 0.65% and 0.02%, respectively. Acute CMV infection and RV infection were more likely to occur in autumn than in the other seasons of the year. Compared with the other three seasons, the difference was statistically significant. The positive rate of TOX-IgG antibody was significantly higher in spring than in the other three seasons. There was no significant difference in specific IgM antibody and IgG antibody between CMV and RV among different age groups. The positive rate of TOX-IgG antibody was 7.23%, 6.41%, 4.28% and 4.7%, respectively, in 20-24 age group, ≥35 age group, 25-29 age group and 30-34 age group, being significantly higher in the first two groups than in the latter two groups. IgM antibodies against CMV, RV and TOX in 2013 were highest in different years, then decreased year by year; in contrast, IgG antibodies increased year by year.ConclusionIn a certain proportion, CMV, RV and TOX infection exists in childbearing women in Chongqing. It is recommended that pre-pregnant women should be screened for CMV, RV and TOX, which will be helpful to guide the proper time of pregnancy. Planning the pregnancy should try to avoid the season of autumn so as to reduce the adverse pregnancy outcomes due to ToRCH infection. Since free pre-pregnancy examination was launched in China, ToRCH infection decreased year by year, indicating that health education can effectively reduce ToRCH infection.
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