诊断风疹病毒感染的研究进展

风疹病毒的诊断对于风疹的监测,预防,判断预后及其恰当的处理措施,都有着重要的理论和现实意义。本文从风疹病毒颗粒,病毒蛋白及其病毒基因3个方面,总结了近年来国外学者对风疹病毒诊断的研究。     

风疹病毒感染与优生

风疹病是引起先天异常的主要病原体之一,本文从风疹病毒的致病作用、发病机理作一综述,以期对风疹病毒先天感染及其严重危害有较全面的认识。     

风疹病毒及其感染的诊断研究进展

风疹病毒因其在优生优育方面的重要作用,一直受到人胶的广泛重视,迄今,许多国家已将风疹疫苗纳入国家免疫规划,继而列入消灭麻疹后的又一个战略目标,并对风疹感染进行监测。风疹病毒感染的诊断是关系到上述行动的重要方面。本文综述了风疹病毒及其感染诊断方面的研究进展,特别是重组病毒抗原原在诊断中的应用。     

风疹病毒核酸的研究现状

对风疹病毒（ＲＶ）ＲＮＡ进行广泛深入的研究是基因工程亚单位疫苗的前提。本文就近几年来国外对ＲＶＲＮＡ的研究进展进行了较详细的阐述,包括基因结构和功能、体外表达等,并将ＲＶＲＮＡ与同科的α病毒ＲＮＡ作了同源性比较分析。     

ELISA法和PCR技术检测孕妇风疹病毒感染的研究

对８７２例孕妇风疹病毒ＩｇＭ检测,结果阳性４１例,阳性率为４．７％,对ＩｇＭ阳性者进一步用ＰＣＲ检测风疹病毒ＲＮＡ,其中１９例阳性,占ＩｇＭ阳怀的４６．３４％,风疹病毒感染与孕龄,职业无关,与孕次有关,与不良孕产史有密切关系。     

B族链球菌感染妊娠妇女产时 抗生素治疗临床效果评价

目的探讨沈阳地区孕晚期妊娠妇女B族链球菌(group B Streptococcus,GBS)的定植率及其耐药性,评估GBS感染妊娠妇女分娩期给予产时抗生素预防(intrapartum antibiotic prophylaxis,IAP)的临床效果。方法选择2017年9月至2017年12月在沈阳市妇婴医院行GBS筛查的691例怀孕35～37周的妊娠妇女为研究对象,将GBS筛查阳性妊娠妇女中采用顺产方式分娩的38例妊娠妇女作为研究组,638例GBS筛查阴性妊娠妇女作为对照组。研究组妊娠妇女给予IAP,对照组妊娠妇女不作处理。分析两组妊娠妇女GBS定植情况、GBS菌株耐药情况及给予IAP后新生儿不良事件发生率。结果 691例妊娠妇女中有53例GBS培养阳性,GBS定植率为7.67%。全部GBS菌株对青霉素、头孢唑林及万古霉素的敏感率均为100.00%;对红霉素、克林霉素耐药率分别为81.48%和73.95%。研究组中新生儿黄疸发生率为7.89%,新生儿窒息发生率为2.63%,脑膜炎、肺炎、败血症的发生率均为0.00%。对照组中新生儿黄疸发生率为3.13%,新生儿窒息发生率为0.63%,肺炎发生率为0.16%,新生儿脑膜炎及败血症发生率均为0.00%。两组新生儿在新生儿黄疸、新生儿窒息、脑膜炎、肺炎和败血症发生率方面比较差异无统计学意义(均P0.05)。结论沈阳地区妊娠妇女GBS带菌率较高,青霉素可作为治疗的首选药物。预防性使用抗生素治疗可以改善新生儿结局。     

ELISA法和PCR技术检测孕妇风疹病毒感染的研究

对８７２例孕妇风疹病毒ＩｇＭ检测,结果阳性４１例,阳性率为４．７％;对ＩｇＭ阳性者进一步用ＰＣＲ检测风疹病毒ＲＮＡ,其中１９例阳性,占ＩｇＭ阳性的４６．３４％。风疹病毒感染与孕龄、职业无关,与孕次有关（χ２＝８．９４,Ｐ＜０．０５）,与不良孕产史有密切关系（χ２＝４．７４,Ｐ＜０．０５）。     

妊娠期妇女生殖道大肠埃希菌感染与妊娠不良结局分析

目的探讨妊娠期妇女生殖道大肠埃希菌感染对妊娠不良结局的影响。方法回顾性分析2011年1月至2013年12月在石家庄市第四医院住院孕产妇共2 053例,进行阴道分泌物细菌培养,对大肠埃希菌培养阳性组与正常对照组的妊娠结局进行分析,以探讨妊娠合并生殖道大肠埃希菌感染与围产期并发症的关系。结果在2 053例围产期妇女中,无致病菌组（对照组）为1230例,大肠埃希菌培养阳性组（感染组）为103例,总患病率为5.02%。感染组与对照组的绒毛膜羊膜炎的发生率分别为78.64%、12.20%（P〈0.01）,产褥感染率分别为24.27%、3.41%（P〈0.01）,新生儿黄疸的发生率58.25%、12.36%（P〈0.01）,胎膜早破率分别为11.65%、10.57%（P〉0.05）,早产率分别为3.88%、3.09%（P〉0.05）,胎儿窘迫的发生率2.91%、2.76%（P〉0.05）,低体重儿的发生率1.94%、2.03%（P〉0.05）。结论妊娠期妇女生殖道大肠埃希菌感染与绒毛膜羊膜炎、产褥感染及新生儿黄疸的发生相关,孕期及早发现、诊断、治疗妊娠期妇女生殖道大肠埃希菌感染是有重要意义。     

哈尔滨地区发热患者风疹病毒的分离鉴定

目的 为了明确哈尔滨地区风疹病毒（Rubella virus,RV）的流行情况,对2003年上半年采集的部分发热患者血清及血细胞进行筛选、鉴定、比较,进行血清学和病原学研究。同时从风疹病毒IgM抗体阳性患者血中分离病毒,对疑似风疹病毒的分离株进行鉴定。方法 采用酶联免疫吸附试验（ELISA）对159例发热患者血清中的风疹病毒IgM进行测定;采用BHK21细胞培养法对风疹病毒IgM抗体阳性患者血标本进行风疹病毒分离,并用RT—PCR、细胞生长曲线、电镜观察、免疫组化等方法对可疑风疹病毒株进行鉴定。结果 风疹病毒IgM抗体阳性为22例,占13．83％;经RT—PCR、细胞生长曲线、电镜观察、免疫组化等方法初步鉴定从血液标本中获得的病毒分离株是风疹病毒。结论 采用FTISA决对该地区159例发热患者血清风疹病毒IgM进行检测,阳性率为13．83％;获得了1株风疹病毒分离株。     

Social determinants associated with Zika virus infection in pregnant women

This study aims to describe the sociodemographic determinants associated with exposure to Zika Virus (ZIKV) in pregnant women during the 2015–2016 epidemic in Salvador, Brazil.MethodsWe recruited women who gave birth between October 2015 and January 2016 to a cross-sectional study at a referral maternity hospital in Salvador, Brazil. We collected information on their demographic, socioeconomic, and clinical characteristics, and evaluated their ZIKV exposure using a plaque reduction neutralization test. Logistic regression was then used to assess the relationship between these social determinants and ZIKV exposure status.ResultsWe included 469 pregnant women, of whom 61% had a positive ZIKV result. Multivariate analysis found that lower education (adjusted Prevalence Rate [aPR] 1.21; 95%CI 1.04–1.35) and food insecurity (aPR 1.17; 95%CI 1.01–1.30) were positively associated with ZIKV exposure. Additionally, age was negatively associated with the infection risk (aPR 0.99; 95%CI 0.97–0.998).ConclusionEve after controlling for age, differences in key social determinants, as education and food security, were associated with the risk of ZIKV infection among pregnant women in Brazil. Our findings elucidate risk factors that can be targeted by future interventions to reduce the impact of ZIKV infection in this vulnerable population.     

Rubella immunity in pregnant women in a north London practice.

Congenital malformations due to rubella embryopathy are preventable. All women embarking on pregnancy should be immune and know that they are immune to rubella to guard against the risk of contracting the disease during pregnancy. A previous history of clinical rubella or rubella vaccination is not reliable, and women should be screened for antibodies when possible before planning to conceive, and particularly before a first pregnancy. As general practitioners committed to the practice of prevention, we should undertake rubella screening for all our women patients before they conceive. This could easily be incorporated into our contraceptive services. We will be greatly helped if family planning clinics adopted a policy of screening for rubella antibodies, always remembering that good documentation and communication will avoid duplication and confusion and reduce costs.     

Prevalence of hepatitis B virus infection in pregnant women in the Montreal area.

From January 1982 to June 1984, 30,315 serum specimens from pregnant women at nine hospitals in the Montreal area were screened for hepatitis B surface antigen (HBsAg). Of the specimens 103, from 98 women, were positive, a prevalence rate of 3.4 per 1000. The ethnic origin of the 98 women and the number who were also positive for e antigen (HBeAg) were as follows: French-Canadian, 29 (3 HBeAg-positive); Asian, 28 (14); Haitian, 32 (0); other, 7 (0); and unknown, 2 (0). The prevalence rates of HBsAg positivity according to ethnic origin at one of the hospitals were 73.9 in Asians, 33.1 in Haitians, 0.9 in French Canadians and 8.0 in women of other extraction. If the prevalence rate found in this study is true for the 95 000 live births that occur yearly in the province of Quebec, there are an estimated 323 infants at risk for hepatitis B virus (HBV) infection each year in the province. Screening programs for detecting HBV carriage in pregnant women should be instituted, since recent studies have shown combined active-passive immunization to be effective in preventing perinatal transmission of HBV infection.     

HIV infection in pregnant women in Chelyabinsk

Data on HIV infection in pregnant women in Chelyabinsk are presented. Starting from 1999, a considerable rise in the number of HIV-infected persons was registered in this city. The social and epidemiological characteristics of HIV-infected pregnant women, as well as the main routes and factors of the infective agent transmission, are given. Relationship between the spread of HIV-infection and drug addiction is revealed. The occurrence of different opportunistic infections in HIV-infected pregnant women is determined.     

Toxoplasma gondii infection in pregnant women in China

Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is one of the most common parasitic infections in humans. Primary infection in pregnant women can be transmitted to the fetus leading to miscarriage or congenital toxoplasmosis. Carefully designed nationwide seroprevalence surveys and case-control studies of risk factors conducted primarily in Europe and America, have shaped our view of the global status of maternal and congenital infection, directing approaches to disease prevention. However, despite encompassing 1 in 5 of the world's population, information is limited on the status of toxoplasmosis in China, partly due to the linguistic inaccessibility of the Chinese literature to the global scientific community. By selection and analysis of studies and data, reported within the last 2 decades in China, this review summarizes and renders accessible a large body of Chinese and other literature and aims to estimate the seroprevalence in Chinese pregnant women. It also reviews the prevalence trends, risk factors, and clinical manifestations. The key findings are (1) the majority of studies show that the overall seroprevalence in Chinese pregnant women is less than 10%, considerably lower than a recently published global analysis; and (2) the few available appropriate studies on maternal acute infection suggested an incidence of 0·3% which is broadly comparable to studies from other countries.     

Prevalence of HIV infection among pregnant women in Newfoundland.

OBJECTIVE: To determine the prevalence of HIV infection among pregnant women in Newfoundland. DESIGN: Anonymous unlinked seroprevalence study. SETTING: Newfoundland. PATIENTS: A total of 14911 women receiving prenatal care or undergoing an abortion, representing nearly all pregnancies in Newfoundland from Nov. 1, 1991, to Oct. 31, 1993. OUTCOME MEASURES: HIV antibody status, as determined by enzyme immunoassay of leftover serum samples (initially obtained for routine screening) and confirmation of reactive samples by the Western blot technique, health region of residence, and age group. RESULTS: Of the 14911 serum samples 13 were positive for HIV, for an overall crude prevalence rate of 1 per 1147 or 8.7 per 10000 pregnant women (95% confidence interval [CI] 4.7 to 14.9). Seven of the positive samples were from women residing in the Eastern Health Region of the province, for a crude prevalence rate of 1 per 376 or 26.6 per 10000 pregnant women (95% CI 10.7 to 54.8) for that region. All women found to be HIV positive were 15 to 29 years of age, the peak prevalence (20.8 per 10000 pregnant women [95% CI 9.5 to 39.4]) was observed among those 20 to 24 years. CONCLUSIONS: The overall prevalence rate of 8.7 per 10 000 pregnant women in Newfoundland is the highest provincial rate recorded among those from similar studies in Canada. Although it may be concluded that there are an estimated 125 HIV-positive women of childbearing age in Newfoundland (95% CI 67 to 213), the age-adjusted estimate is 84 (95% CI 36 to 131). This study provides an independent confirmation of an outbreak of HIV infection among women in the Eastern Health Region of the province.     

乙肝孕妇宫内感染监测与HBVM评估

目的监测孕妇产前感染HBV与宫内感染情况,评估乙肝孕妇血清中乙肝血清标志物（HBVM）对宫内感染HBV的风险大小,指导育龄妇女早期预防宫内感染。方法采用ELISA法检测孕妇血清乙肝标志物（HBVM）6项,即HBsAg、HBsAb、HBeAg、HBeAb、HBcAb与Pre-S1;筛选乙肝携带者采用实时荧光定量PCR法进行HBV DNA检测;应用ELISA法对新生儿24h内（免疫接种前）外周血HBsAg、Pre-S1和、HBeAg进行检测。结果1002例孕妇中乙肝感染率为10．6％,106例乙肝孕妇宫内感染34例,宫内感染率为32％。HBeAg（＋）者宫内感染风险率最高为77％,HBV DNA（＋）与Pre-S1（＋）次之。HBV DNA（-）宫内感染风险率最低为2％,HBeAg（-）与Pre-S1（-）次之。结论乙肝孕妇宫内感染率较高;HBeAg（＋）孕妇宫内感染HBV风险最高,可作为育龄妇女采取措施积极预防宫内感染的指标。HBV DNA（-）宫内感染率最低,可作为育龄妇女宫内安全的评估指标。Pre-S1是宫内感染的有利补充指标。