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母体抗巨细胞病毒免疫球蛋白M抗体水平的检测能否用于筛查胚胎和胎儿的巨细胞病毒感染?

Can measurement of maternal anti-cytomegalovirus immunoglobulin-M antibody levels be used to screen for cytomegalovirus infection in embryos and fetuses?

作者信息

Yoshida Masashi, Matsuda Hideo, Yoshinaga Yosuke, Asai Kazuhiko, Kawashima Akihiro, Sei Kiguna, Furuya Kenichi

机构信息

Department of Obstetrics and Gynecology, National Defense Medical College Division of Obstetrics and Gynecology, Matsuda Perinatal Clinic Division of Obstetrics and Gynecology, Self-Defense Forces Central Hospital, Tokorozawa, Japan.

出版信息

J Obstet Gynaecol Res. 2013 Jan;39(1):166-9. doi: 10.1111/j.1447-0756.2012.01900.x. Epub 2012 Jun 4.

Abstract

AIMS

Our study aims to estimate whether measurement of maternal anti-cytomegalovirus immunoglobulin-M antibody (CMV-IgM) levels are useful as a screening method for achieving early detection of congenital CMV infection.

MATERIAL AND METHODS

Levels of maternal CMV-IgM were measured by enzyme immunoassay in all (n =2865) pregnant women who visited our hospital in the first trimester during the period from January 2005 to December 2009.

RESULTS

Among them, 21 individuals (0.73%) had a CMV-IgM titer of ≥0.08 and were judged to be CMV-IgM-positive. Informed consent was obtained from all 21 individuals to perform the confirmation test that quantifies the levels of cytomegalovirus DNA (CMV-DNA) in amniotic fluid by real-time polymerase chain reaction. However, only one (0.03%) of the 21 individuals was CMV-DNA-positive (CMV-DNA concentration, 1.0 × 10(4) copies/ml).

CONCLUSION

In order to detect congenital CMV infection in early pregnancy, it is considered appropriate to use ultrasound for close examination of embryo or fetal symptoms indicative of CMV instead of performing serological screening based on CMV-IgM.

摘要

目的

我们的研究旨在评估检测孕妇抗巨细胞病毒免疫球蛋白M抗体(CMV-IgM)水平作为早期检测先天性巨细胞病毒感染的筛查方法是否有用。

材料与方法

对2005年1月至2009年12月期间在我院孕早期就诊的所有孕妇(n = 2865)采用酶免疫法检测孕妇CMV-IgM水平。

结果

其中,21例(0.73%)孕妇CMV-IgM滴度≥0.08,被判定为CMV-IgM阳性。所有21例孕妇均签署知情同意书,通过实时聚合酶链反应对羊水巨细胞病毒DNA(CMV-DNA)水平进行定量确认检测。然而,21例孕妇中仅1例(0.03%)CMV-DNA阳性(CMV-DNA浓度为1.0×10⁴拷贝/ml)。

结论

为了在孕早期检测先天性巨细胞病毒感染,认为采用超声密切检查胚胎或胎儿是否有巨细胞病毒感染相关症状比基于CMV-IgM进行血清学筛查更为合适。

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