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在中国恰当使用 TORCH 筛查?-来自中国西北部一家教学医院的三年结果。

TORCH screening used appropriately in China?─three years results from a teaching hospital in northwest China.

机构信息

The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.

Xi'an NO.3 Hospital, Xi'an, Shaanxi Province, China.

出版信息

BMC Pregnancy Childbirth. 2019 Dec 9;19(1):484. doi: 10.1186/s12884-019-2642-7.

Abstract

OBJECTIVES

TORCH infections caused by Toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus 1,2 (HSV-1,2) are associated with congenital anomalies. The study aimed to analyze the characteristics of TORCH screening in reproductive age women.

METHODS

A total of 18,104 women (2015-2017) from a teaching hospital in Xi'an, China, were enrolled in the study. The characteristics of TORCH screening, i.e., the application of TORCH test, the seroprevalence, the impact of age, periods of gestation and woman with bad obstetric history (BOH) on the serological data were investigated.

RESULTS

In the study, 319 women (1.76%) performed dynamic TORCH test. 51.66, 20.44 and 3.83% of the population did the test in the pre-gestation period, the first and third trimester, respectively. Quite a few pre-gestation women (29.74%) ignored screening of IgG antibodies. The overall IgG/IgM seropositvity of TOX, RV, CMV, HSV-1 and HSV-2 was 4.35%/0.35, 90%/0.63, 96.79%/0.97, 81.11%/0.14 and 6.1%/0.19%, respectively. The age-specific distributions and periods of gestation had no significant effect on the seroprevalence of TORCH agents, p>0.05. However, BOH was significantly associated with higher seropositvity of IgM (RV, CMV, HSV-1 and HSV-2) and IgG (CMV and HSV-1) antibodies, p < 0.05.

CONCLUSION

In Xi'an region, more attentions should be paid to TOX, CMV, HSV-2 and the women with BOH for TORCH screening. Meanwhile, a greater emphasis needs to be placed on TORCH test used inappropriately in China.

摘要

目的

弓形虫(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)和单纯疱疹病毒 1、2(HSV-1、2)引起的 TORCH 感染与先天畸形有关。本研究旨在分析育龄妇女 TORCH 筛查的特点。

方法

本研究纳入了来自中国西安一所教学医院的 18104 名女性(2015-2017 年)。研究了 TORCH 筛查的特点,即 TORCH 检测的应用、血清流行率、年龄、妊娠时期和不良产科史(BOH)对血清学数据的影响。

结果

在研究中,319 名女性(1.76%)进行了动态 TORCH 检测。分别有 51.66%、20.44%和 3.83%的人群在妊娠前、第一和第三孕期进行了检测。相当多的妊娠前妇女(29.74%)忽略了 IgG 抗体的筛查。TOX、RV、CMV、HSV-1 和 HSV-2 的总 IgG/IgM 阳性率分别为 4.35%/0.35、90%/0.63、96.79%/0.97、81.11%/0.14 和 6.1%/0.19。年龄特异性分布和妊娠时期对 TORCH 病原体的血清流行率没有显著影响,p>0.05。然而,BOH 与 IgM(RV、CMV、HSV-1 和 HSV-2)和 IgG(CMV 和 HSV-1)抗体的高阳性率显著相关,p<0.05。

结论

在西安地区,应更加关注 TORCH、CMV、HSV-2 和 BOH 妇女的 TORCH 筛查。同时,应更加重视中国 TORCH 检测的不当应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1938/6902533/da245ec7c9b4/12884_2019_2642_Fig1_HTML.jpg

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