医学检验信息网 检验医学 2007-2-26 16:16:49

单位：430079 武汉 湖北省医学科学院病毒所(龚镇奎 骆林 肖红雨 黄鹤 李静)；湖北省卫生防疫站门诊部(周学文 谌树青)

关键词: ToRCH；流行病学调查；ELISA 【摘要】 目的 探讨武汉地区ToRCH流行规律。方法 采用检测血清中ToRCH特异性IgM抗体的血清学方法，对武汉地区正常人群ToRCH感染的情况进行了全年度(1997年3月～1998年2月)逐月监测。结果 弓形体(Toxo)、风疹病毒(RuV)、巨细胞病毒(CMV)和单纯性疱疹(HSV)IgM全年的平均阳性率分别为5.8%、7.5%、4.2%和4.9%。同时显示出武汉地区ToRCH流行具有3大特点：(1)RuV流行有明显的季节变化，春季(3、4、5)月份感染率最高(8.5%、19.5%、14.0%)；Toxo、CMA和HSV季节变化不明显；(2)成年人多为无明显临床症状的不显性感染；(3)ToRCH 4项合并感染的情况普遍存在，本年度的合并感染率为2.6%。结论 RuV对孕妇的感染易引起胎儿先天畸形，根据其季节流行特点，在春季孕妇尽量少到公共场所活动，以免孕妇遭RuV感染。 Preliminary study on ToRCH epidemic laws in Wuhan Region GONG Zhenkui, LUO Lin, XIAO Hongyu, et, al. Institute of Virology, Hubei Academy of Medical Sciences, Wuhan 430079 【Abstract】 Objective To investigate the ToRCH epidemic law in Wuhan region.Methods The ToRCH infection in the normal populations of Wuhan region was inspected through a whole year (from Mar. 1997 to Feb. 1998) by detecting the specific IgM antibodies to ToRCH in sera.Results The results showed that in the whole year, the average positive rates of IgM aitibodies to Toxo, RuV, CMV and HSV were 5.8%, 7.5%, 4.2% and 4.9% respectively. Three characteristics of the ToRCH epidemic in the region were concluded: (1) The epidemic of RuV obviously changed with seasons. Its infection rates were the highest (8.5%, 19.5%, 14.0%) during spring (March, April and May). However, the changes of Toxo, CMV and HSV were not obvious with seasons; (2) The adult infections were mainly recessive, which had no apparent clinical symptoms; (3) The cross infections of the four pathogens were common, the cross-reaction rate of the surveyed year was 2.6%.Conclusions RuV infection of pregnant woman may result in congenital malformation of the emlbryo. Accoroling to the seasonal epidemic charactaristics of RuV, women in pregnancy had better not to go to the public places during the sping seasons (March, April, May) as far as possible. 【Key words】 ToRCH Epidemiological inspection ELISA ToRCH是弓形体(Toxoplasma gondii, To)(Rubella virus, R) (Cytomegalo virus, C) (Herpes simplex virus, H)4种病原微生物英文字头的缩写。这4种病原体广泛感染人类引起多种疾病，尤其是孕妇感染后，容易引起胎儿先天畸形，因而引起人们的广泛重视。我们采用查血清中特异性ToRCH IgM抗体的血清学方法，对武汉地区正常人群中ToRCH感染情况进行1年的逐月监测，并根据血清学资料对其流行规律进行了初步探讨。 1 材料和方法

1.1 监测对象 武汉地区宾馆、饭店、娱乐场所、饮食服务行业从业人员，从1997年3月～1998年2月，每月采集100～200份血清进行ToRCH4项IgM检测。

1.2 ToRCH IgM间接ELISA诊断试剂盒 由本所研制生产^［1］，批号：970301，970801，980301，试剂的批间、批内变异系数(C.V)均在10%以下。

1.3 检测方法 按试剂使用说明书进行，凡IgM阳性血清都进行两次以上重复，凡ToRCH4项IgM均为阳性的血清，都加试了RF因子凝集试验，以证实检测出的IgM阳性并非RF因子影响所致。

表1 武汉地区正常人群ToRCH IgM抗体全年各月检出阳性率 Tab.1 The positive detection rate of serum ToRCH IgM in normal popualtions in Wuhan Regon in difrerent months of a whole year(1997.3～1998.2)

采样时间(月) Sample collection (Month)	检测人数 No. tested	Toxo	RuV	CMV	HSV
阳性数 Positive no.	阳性率(%) Positive rate	阳性数 Positive no.	阳性率(%) Positive rate	阳性数 Positive no.	阳性率(%) Positive rate	阳性数 Positive no.	阳性率(%) Positive rate
1	100	6	6.0	2	2.0	3	3.0	2	2.0
2	100	5	5.0	2	2.0	5	5.0	4	4.0
3	200	13	6.5	17	8.5	3	1.5	10	5.0
4	200	10	5.0	39	19.5	6	3.0	5	2.5
5	200	10	5.0	28	14.0	11	5.5	14	7.0
6	200	10	5.0	14	7.0	13	6.5	13	6.5
7	200	15	7.5	13	6.5	14	7.0	10	5.0
8	100	4	4.0	5	5.0	4	4.0	2	2.0
9	100	5	5.0	3	3.0	4	4.0	2	2.0
10	100	7	7.0	2	2.0	1	1.0	4	4.0
11	100	6	6.0	2	2.0	4	4.0	4	4.0
12	100	8	8.0	2	2.0	3	3.0	2	2.0
合计 Total	1700	99	5.8	129	7.5	71	4.2	84	4.9

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