摘要
目的探讨先天性心脏病(CHD)与母亲孕期感染的关系。方法问卷式调查、统计母孕期感染史;采用ELISA法对孕妇的血清进行各病原体包括人细小病毒B19(HPV19)、弓形体(TOX)、风疹病毒(RV)、单纯疱疹病毒2(HSV2)、巨细胞病毒(CMV)抗体检查。结果①36例病例组(CHD组)和72例对照组(Non-CHD组)母孕期感冒、腹泻、乙型肝炎、阑尾炎的发病率及饲养宠物率分别为63.9%、5.6%、5.6%、2.8%、5.6%和38.9%、4.2%、2.8%、0%、1.4%,其中孕早期(胎龄<12周)与孕中后期(胎龄≥12周)感冒的发病率分别为44.4%、19.5%和16.7%、22.2%,比较孕期感冒,尤其孕早期感冒在两组中的感染率差异有统计学意义(P均<0.05),而腹泻、乙肝、阑尾炎的感染率及饲养宠物率两组差异无统计学意义(P>0.05)。②病例组和对照组母孕20～38周的血清中HPVB19、TOX、RV、HSV2的IgG的阳性率分别为38.9%、22.2%、27.8%、33.3%、8.3%和12.5%、4.2%、5.6%、29.2%、5.6%,两组IgM的阳性率分别为13.9%、2.8%、8.3%、11.1%、0%和4.2%、1.4%、0%、6.9%、1.4%,两组比较HPVB19、TOX、RV的IgG阳性率差异有统计学意义(P<0.05),CMV、HSV2阳性率两组差异无统计学意义(P>0.05),HPVB19、TOX、RV、CMV、HSV2的IgM阳性率差异无统计学意义(P>0.05)。结论先天性心脏病与母亲孕期感冒,尤其孕早期感冒有关;先心病胎儿的母亲孕前和(或)孕早期感染HPVB19、TOX、RV可能与先天性心脏病有关,需进一步对引产先心病胎儿心肌组织进行相关病原体基因检测来验证这一结论。
Objective To explore the relationship between congenital heart disease （CHD） and infection during pregnancy. Methods A total of 300 pregnant women were enrolled and underwent fetal heart ultrasound in Xijing hospital. The infections during pregnancy had been recorded by questionnaire. The antibodies IgG and IgM of various pathogen （HPVB19, TOX, RV, CMV, HSV2） in serum were detected by ELISA. Tile pregnant women were divided by 1 ： 2 ratio into case group （CHD group, 36 cases） and control group （Non-CHD group, 72 cases）. Results （1） The rates of flu, diarrhea, hepatitis B, acute appendicitis and pet-keeping in the CHD group during pregnancy were 63.9%, 5.6%, 5.6%, 2.8% and 5.6%, respectively, while those in Non-CHD group were 38.9%, 4.2%, 2.8%, 0% and 1.4%, respectively. The rates of flu before and after 12 weeks gestation in CHD group were 44.4% and 19.5%, and those in Non-CHD group were 16.7% and 22.2%, respectively （P 〈 0.05）. The difference of the rate of flu before 12 weeks gestation between two groups was most notable （P = 0.002）. There were no statistical differences for the rates of diarrhea, hepatitis B, acute appendicitis and pet-keeping between two groups （P 〉 0.05）. （2） The positive rates of serum antibody IgG of HPVB19, TOX, RV, CMV and HSV2-IgG in CHD group were 38.9%, 22.2%, 27.8%, 33.3% and 8.3%, respectively, while those in Non-CHD group were 12.5%, 4.2%, 5.6%, 29.2% and 5.6%, respectively. The positive rates of serum antibody IgM in CHD group were 13.9%, 2.8%, 8.3%, 11.1% and 0%, respectively, while those in Non-CHD group were 4.2%, 1.4%, 0% , 6.9% and 1.4%, respectively. The positive rates of antibody IgG of HPVB19, TOX and RV were all significantly different between the groups （P 〈 0.05）, while there were no statistical difference （P 〉 0.05） for the positive rates of antibody IgG of CMV and HSV2 between two groups.The positive rate of serum antibody IgM was also no statistically difference between two groups （P 〉 0.05）. Conclusions CHD is related to flu during pregnancy, especially in early pregnancy. CHD is probably related to HPVB19, TOX, and RV infections pre and/or during early pregnancy, which need to be verified by dectecting related pathogen genes of fetus myocardial tissue.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2010年第7期649-652,共4页
Journal of Clinical Pediatrics
基金
国家高科技研究发展计划(八六三计划)课题(No.2007AA02Z442)
关键词
先天性心脏病
孕期
感染
congenital heart disease
pregnancy
infection
