Objective To study the diagnostic value of human cytomegalovirus (HCMV) late mRNA detection in active intrauterine infection.Methods The HCMV late mRNA in peripheral blood of 42 HCMV IgM positive pregnant women an d their fetal attachments (such as chorionic villi, amniotic fluid, umbilical bl ood and placenta) were detected by reverse transcription polymerase chain reacti on (RT-PCR).Results Late mRNA was detected in 23 of 42 HCMV IgM positive cases, a rate of 54.3%. Fetal appendages in 13 cases of late mRNA positive mothers were also tested, of which 7 were positive, with a vertical transmission rate of 53.8%. In 12 late m RNA negative mothers, only 1 case of fetal appendages tested was positive, with a vertical transmission rate of 8.3%. There was significant difference between the transmission rates of these two groups.Conclusions Positive results of HCMV IgM cannot accurately reflect the activity of HCMV at t he time of testing. However, the activity of HCMV is closely related to the mot her-fetus vertical transmission rate. As an indicator of active HCMV infection, late mRNA can not only reflect the mother-fetus transmission rate during active HCMV infection, but also provide some information about HCMV activity in fetal tissue.%目的探讨人巨细胞病毒晚期mRNA检测在宫内活动性感染中的应用价值.方法采用逆转录-PCR法对42例HCMV-IgM阳性孕妇外周血及部分胎儿附属物进行 HCMV晚期mRNA 检测.结果 42例IgM阳性孕妇检出晚期mRNA 23例,两者符合率为54.7%.对其中13例mRNA阳性孕妇胎儿附属物进行检测发现7例阳性,母婴传播率为53.8%;而12例mRNA阴性HCMV-DNA阳性孕妇胎儿附属物中仅1例阳性,母婴传播率为8.3%;两者有非常显著性差异.结论 HCMV-IgM的阳性结果并不能完全准确地反映受检时HCMV的活动状态.HCMV的活动状态与母婴传播率密切相关,mRNA的检测不仅能够正确反映HCMV活动性感染时的宫内传播率,而且可以了解受检时胚胎或胎儿组织内HCMV的活动状态,并估计其愈后.
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