目的:研究足月新生儿巨细胞病毒抗体(antibodies against cytomegalovirus, CMV IgG)的母胎转运和新生儿出生至2岁CMV IgG的动态变化。方法:用固相酶联免疫法定量检测112例单胎足月孕妇及其新生儿脐血的CMV IgG浓度,动态观察41例新生儿1月龄、3.5月龄、8月龄及2岁时体内CMV IgG浓度及IgM的变化。结果:在112例孕妇中108例(96.43%)CMV IgG阳性,其新生儿脐血也阳性;CMV IgG平均浓度新生儿(770.35IU·ml-1)高于孕妇(654.20IU·ml-1) (t=5.08,P<0.001);脐血CMV IgG浓度与母体水平呈高度相关(r=0.87,P<0.001)。所有新生儿无CMV感染的临床表现,随访期间也无症状。112例脐血CMV IgM均阴性。41例随访婴儿中,32例(78.05%)8月龄时CMV IgG明显升高,提示CMV感染;其中1月和3.5月龄时分别有4例(13.3%)和21例(70%)CMV IgM转为阳性。另外8例CMV IgG在8月龄时转阴,2岁时仍为阴性;1例CMV IgG阴性母亲分娩的新生儿从出生到2岁时CMV IgG仍为阴性,说明未感染CMV。母源性CMV IgG在新生儿体内半衰期约39d。结论:母源性CMV IgG可通过胎盘到达胎儿体内;在CMV感染的婴幼儿中,大部分原发感染发生在1~3.5月龄之间,但因存在母源性抗体而无临床表现。 |
Objective: To investigate transplacental transfer of antibodies against cytomegalovirus(CMV IgG) and to observe the longitudinal profile of CMV IgG in full term infants from newborn to 2 years old. Methods:CMV IgG and IgM in paired serum samples from 112 infants and their mothers were determined with ELISA. Longitudinal sera from 41 infants at 1, 3.5, 8, and 24 months old were tested for CMV IgG and IgM respectively. Results:Of the 112 mothers, 108(96.43%) were CMV IgG positive; their 108 infants were also seropositive. CMV IgG level in infants was higher than that in mothers(770.35 vs. 654.20 IU·ml-1, t=5.08, P<0.001), yet they were well correlated(r=0.87, P<0.001). All infants had no symptoms related with CMV infection after birth and during the follow-up. All 112 umbilical sera was negative for CMV IgM. In follow-up, 32 of 41(78.05%) infants had increased CMV IgG levels at 8 months old, indicating CMV infection. of 32 infected infants, 4(13.3%) and 21(70%) were CMV IgM positive at age of 1 and 3.5 months respectively. And 8 others' CMV IgG was negative at 8 months old, and another one infant of seronegative mother was always CMV IgG negative till 2 years old, indicating no infection. The mean half-life of maternal CMV IgG in infants was estimated to be 39 days. Conclusions: CMV IgG can efficiently transfer through placenta. The infants can infect CMV,the majority of primary infection occures in the age of 1-3.5 months, but they have no symptoms related because of the presence of the maternal IgC. |
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