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目的了解安国市孕妇弓形虫感染状况及其对妊娠结局的影响。方法采用酶联免疫吸附试验(ELISA)检测3 891例孕妇外周血中弓形虫IgM和IgG抗体。根据检测结果分为急性感染组、既往感染组、活动性感染组,随机抽取200名检测结果为阴性的无弓形虫感染的孕妇作为对照组,对4组孕妇进行随访,观察比较其妊娠结局。结果在3 891例被调查的孕妇中,弓形虫感染353例,其中急性感染51例、既往感染197例、活动性感染105例,总感染率为9.07%(353/3 891);对应各感染组及对照组不良妊娠结局发生率分别为17.65%(9/51)、2.03%(4/197)、6.67%(7/105)和1.50%(3/200)。急性感染组和活动性感染组不良妊娠结局发生率与对照组比较,差异有统计学意义(P<0.05);既往感染组不良妊娠结局发生率与对照组比较,差异无统计学意义(P>0.05)。郊区孕妇弓形虫阳性率高于市区妇女,农民阳性率高于工人、干部和其他职业者,有动物密切接触史和喜食生食者阳性率较高,差异均有统计学意义(P<0.05)。结论急性感染和活动性感染与孕妇不良妊娠结局密切相关。建议孕妇加强弓形虫筛查工作,以便及早诊治;加强健康教育,改变不良生活习惯;加强水源、粪便等卫生管理。
Objective To understand the status of Toxoplasma gondii infection in pregnant women in Anguo and its effect on pregnancy outcome. Methods Toxoplasma IgM and IgG antibodies in peripheral blood of 3 891 pregnant women were detected by enzyme-linked immunosorbent assay (ELISA). According to the test results, divided into acute infection group, past infection group and active infection group, 200 pregnant women with negative Toxoplasma gondii infection were randomly selected as the control group. Four groups of pregnant women were followed up and their pregnancy outcomes were observed. Results Of the 3 891 pregnant women surveyed, 353 were infected with Toxoplasma gondii, including 51 acute infections, 197 previous infections and 105 active infections. The overall infection rate was 9.07% (353/3 891) The incidence of adverse pregnancy outcomes were 17.65% (9/51), 2.03% (4/197), 6.67% (7/105) and 1.50% (3/200), respectively. The incidence of adverse pregnancy outcomes in acute infection group and active infection group was significantly higher than that in control group (P <0.05). There was no significant difference in the incidence of adverse pregnancy between previous infection group and control group (P> 0.05). The positive rate of toxoplasma in pregnant women in suburbs was higher than that in urban areas. The positive rate of peasants in workers in the suburbs was higher than those in workers, cadres and other occupations. There was a high positive rate of animals in close contact with history and eating eaters, with significant differences (P <0.05 ). Conclusions Acute and active infections are closely related to adverse pregnancy outcomes in pregnant women. Proposed pregnant women to strengthen the screening of Toxoplasma gondii in order to facilitate early diagnosis and treatment; strengthen health education and change bad habits; strengthen water, manure and other health management.