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[孕妇弓形虫感染的诊断困难。聚合酶链反应能否解释疑问?]

[Diagnostic difficulties of Toxoplasma gondii infection in pregnant women. Is it possible to explain doubts by polymerase chain reaction?].

作者信息

Sławska Helena, Czuba Bartosz, Gola Joanna, Mazurek Urszula, Włoch Agata, Wilczok Tadeusz, Kamiński Kazimierz

机构信息

Klinika Perinatologii i Ginekologii w Zabrzu, SlAM.

出版信息

Ginekol Pol. 2005 Jul;76(7):536-42.

Abstract

OBJECTIVES

Toxoplasma gondii infection during pregnancy is still a difficult problem in the contemporary perinatology. Difficulties met during interpretation of serological tests carried out in pregnant patients to detect Toxoplasmosis implies more and more frequent use of the Polymerase Chain Reaction (PCR).

DESIGN

To evaluate the dependence between serological tests and quantity of the Toxoplasma gondii genomes in mothers' blood and amniotic fluid or neonatal blood, the quantitative PCR (q-PCR) method was applied.

MATERIALS AND METHODS

The analysis was performed in 81 pregnant women. Maternal blood, amniotic fluid and newborns' umbilical blood samples were evaluated for the presence of Toxoplasma gondii DNA. IgG and IgM Toxoplasma gondii antibodies were evaluated by the ELISA method.

RESULTS

High seroprevalence (51.9%) of the Toxoplasma gondii was confirmed. Toxoplasma gondii genetic material in blood and/or amniotic fluid was found in 33 patients. It was stated that quantity of the protozoa and anti-IgM presence in mothers' blood are the factors influencing significantly the Toxoplasma gondii manifestation in amniotic fluid.

CONCLUSION

High suitability of PCR in diagnosis of Toxoplasmosis during pregnancy and vertical transmission was confirmed.

摘要

目的

孕期弓形虫感染仍是当代围产医学中的一个难题。在对孕妇进行血清学检测以诊断弓形虫病时遇到的困难意味着聚合酶链反应(PCR)的使用越来越频繁。

设计

为了评估血清学检测与母亲血液、羊水或新生儿血液中弓形虫基因组数量之间的相关性,采用了定量PCR(q-PCR)方法。

材料与方法

对81名孕妇进行了分析。对孕妇血液、羊水和新生儿脐带血样本进行了弓形虫DNA检测。采用ELISA法检测弓形虫IgG和IgM抗体。

结果

证实弓形虫血清阳性率较高(51.9%)。在33例患者的血液和/或羊水中发现了弓形虫遗传物质。结果表明,母亲血液中弓形虫数量和抗IgM的存在是显著影响羊水中弓形虫表现的因素。

结论

证实了PCR在孕期弓形虫病诊断及垂直传播诊断中的高度适用性。

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