摘要:
Objective The purpose of this study was to explore the infection characteristic of Toxoplasma gondii (TOX),Rubella virus (RV),Cytomegalovirus (CMV) and Herpes simplex virus Ⅱ type (HSV-Ⅱ) (TORCH) infection in neonate in Tianjin area.Methods TOX-IgM/IgG,RV-IgM/IgG,CMV-IgM/IgG and HSV-Ⅱ-IgM/IgG were detected in serum of 2 273 neonate during 2015~2016 with enzymelinked immunosorbent assay (ELISA).Results The positive rates of TOX IgM,RV-IgM,CMV-IgM and HSV-Ⅱ-IgM were 0.00%(0/2 273),0.00%(0/2 273),0.88%(20/2 273) and 0.00%(0/2 273),respectively and those of TOX-IgG,RV-IgG,CMV-IgG and HSV-Ⅱ-IgG were 3.65% (83/2 273),86.45% (1 965/2 273),95.82%(2 178/2 273) and 8.27%(188/2 273),respectively.There was 0.66% percent (15/2 273) of examinees who were infected by none of TORCH pathogens.There existed significant statistical difference for positive rate between TOX-IgG,RV-IgG,CMV-IgG and HSV-Ⅱ-IgG (x2 =6.747,P =0.000) with consequence of the highest positive rate being CMV-IgG.The positive rates of TOX-IgG and CMV-IgM in neonate of 2016 were significantly less than those in 2015 (x2 =5.789~7.505,P=0.006~0.016) but that of HSV-Ⅱ-IgG of 2016 was statistically higher than that in 2015 (x2 =6.073,P =0.014).The positive rate of CMV-IgM in male neonate in 2015 was significantly higher than that in 2016 (x2 =5.054,P =0.025).As a whole the positive rates of TOX-IgG,RV-IgG,CMV-IgG and HSV-Ⅱ IgG had no differences between different years,so did those between gender groups (x2 =2.23~6.963,P=0.073~0.526).The positive rates of TOX-IgG,RV IgG,CMV-IgG and HSV-Ⅱ-IgG in female neonate in 2015 were statistically different from those in 2016 (x2 =8.247,P =0.041).The female neonate in 2015 had higher infection proportion of TOX-IgG compared with that in 2016 (x2 =6.992,P=0.008).TORCH infection detected in 2 273 cases of neonate had one pathogen infection and multi-pathogen infection with overall six patterns of TORCH infection and all infection patterns had no relationship with year and gender,respectively (P>0.05).Conclusion RV and CMV were primary pathogens in TORCH infection for neonate in Tianjin area and there were recent infections by CMV.TORCH infection varied in different years and gender groups,which provided experimental data and basis for epidemiology and prevention of TORCH in neonate.%目的 探讨天津地区新生儿感染弓形体(Toxoplasma gondii,TOX)、风疹病毒(Rubella virus,RV)、巨细胞病毒(Cytomegalovirus,CMV)和单纯疱疹病毒Ⅱ型(Herpes simplex virusⅡtype,HSV-Ⅱ)(TORCH)状况及特点.方法 利用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测2015~2016年2 273例出生后28天内新生儿血清中TOX-IgM/IgG,RV-IgM/IgG,CMV-IgM/IgG和HSV-Ⅱ-IgM/IgG.结果 在2 273例新生儿中TOX-IgM,Rv-IgM,CMV-IgM和HSV-Ⅱ-IgM的阳性率分别为0.00%(0/2 273),0.00%(0/2 273),0.88%(20/2 273)和0.00%(0/2273),TOX-IgG,RV-IgG,CMV-IgG和HSV-Ⅱ-IgG的阳性率分别为3.65%(83/2 273),86.45%(1 965/2 273),95.82%(2178/2 273)和8.27%(188/2 273),未感染TORCH病原体的新生儿占0.66%(15/2 273);TOX-IgG,RV-IgG,CMV-IgG和HSV-Ⅱ-IgG阳性率之间差异有统计学显著性意义(x2=6.747,P=0.000),检出率最高的为CMV-IgG;2016年新生儿血清中TOX-IgG和CMV-IgM阳性率均明显低于2015年(x2=5.789~7.505,P=0.006~0.016),而2015年男性新生儿中CMV-IgM阳性率明显高于2016年(x2=5.054,P=0.025);总体上TOX-IgG,RV-IgG,CMV-IgG和HSV-Ⅱ-IgG(TORCH-IgG)阳性率在各年度和不同性别受检者之间差异均无统计学意义(x2=2.23~6.963,P=0.073~0.526),而2015年度女性新生儿TORCH-IgG阳性率与2016年相比差异有统计学意义(x2=8.247,P=0.041);2015年女性受检者TOX-IgG阳性率高于2016年女性新生儿(x2=6.992,P=0.008);TORCH检测结果中存在单一病原体感染和多种病原体感染共六种感染模式,各年度之间以及不同性别之间TORCH感染模式差异均无统计学显著性意义(P>0.05).结论 天津地区新生儿TORCH既往感染以RV和CMV为主,新近感染皆为CMV,TORCH在不同年份及不同性别受检者中阳性率有明显变化,该研究为新生儿TORCH的流行病学以及防治提供实验资料和依据.