McGregor J A, Mark S, Crawford G P, Levin M J
Am J Obstet Gynecol. 1987 Aug;157(2):281-4. doi: 10.1016/s0002-9378(87)80151-5.
Appropriate use of varicella zoster immunoglobulin to prevent or ameliorate maternal or perinatal infection depends on accurate identification of varicella-susceptible women. Detection of fluorescent antibody to varicella zoster virus membrane antigen is an available means for identifying women exposed to varicella who are at risk for infection. During a 5 1/2-year period, 37 pregnant women who had been exposed to varicella and who had a negative or indeterminate history of prior varicella were tested for the presence of varicella zoster virus membrane antigen. Among the 17 women with a negative history, 12 (71%) had a positive test result and five (29%) had a negative test result. Among 20 women with undeterminant histories, 18 (90%) were immune and two (10%) were susceptible. Three additional women who were tested despite a history of varicella had positive varicella zoster virus membrane antigen test results. Overall, 81% of patients with a negative or uncertain history of varicella had serologic evidence of past varicella. One of six untreated seronegative women and one weakly positive woman developed disease. There was no instance of congenital varicella. Expeditious determination of varicella zoster virus membrane antigen or equivalent anti-varicella antibody status in pregnant women exposed to varicella appears to be a rapid, satisfactory method for determining who should promptly receive varicella zoster immunoglobulin passive immunization.
合理使用水痘带状疱疹免疫球蛋白预防或改善母体或围产期感染取决于对水痘易感女性的准确识别。检测水痘带状疱疹病毒膜抗原的荧光抗体是识别接触水痘且有感染风险女性的一种可行方法。在5年半的时间里，对37名接触过水痘且既往水痘病史阴性或不确定的孕妇进行了水痘带状疱疹病毒膜抗原检测。在17名病史阴性的女性中，12名（71%）检测结果为阳性，5名（29%）检测结果为阴性。在20名病史不确定的女性中，18名（90%）有免疫力，2名（10%）易感。另外3名尽管有水痘病史但仍接受检测的女性水痘带状疱疹病毒膜抗原检测结果为阳性。总体而言，81%水痘病史阴性或不确定的患者有既往水痘的血清学证据。6名未治疗的血清阴性女性中有1名以及1名弱阳性女性发病。未出现先天性水痘病例。对接触水痘的孕妇快速测定水痘带状疱疹病毒膜抗原或等效的抗水痘抗体状态似乎是确定谁应立即接受水痘带状疱疹免疫球蛋白被动免疫的一种快速、令人满意的方法。
