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目的:了解孕妇宫颈沙眼衣原体(CT)、肺炎衣原体(CP)感染及母婴传播情况,探讨其与围产期疾病的关系。方法:于妊娠晚期收集孕妇宫颈脱落细胞,于分娩时收集羊水、新生儿口咽分泌物,应用套式 PCR 方法检测 CT、CP DNA 的存在。结果:(1)宫颈分泌物 CT 阳性率:异常妊娠纽14.0%明显高于正常妊娠组的3.2%(P<0.01);CP 阳性率:宫内发育迟缓(IUGR)组11.1%高于正常妊娠组的1.1%(P<0.05)。(2)羊水 CT、CP 阳性率:宫颈阳性组分别为28.6%及60%,均明显高于宫颈阴性组(P<0.05及 P<0.01)。(3)新生儿咽拭子 CT 阳性率:宫颈阳性组36.8%明显高于宫颈阴性组的5.6%(P<0.001),CP 阳性率:宫颈阴性组7.0%而阳性组则为0。结论:CT、CP 均可引起孕妇生殖道感染并垂直传播,新生儿 CT 感染主要来自产道,而 CP 则以宫内感染为主。IUGR 早产、胎膜早破、畸胎死胎史与衣原体感染有关,有必要对孕妇作筛查及治疗以阻断母婴传播。
Objective: To understand the status of pregnant women with Chlamydia trachomatis (CT), Chlamydia pneumoniae (CP) and mother-to-child transmission, and to explore the relationship with perinatal diseases. Methods: Pregnant women with cervical exfoliated cells were collected during the third trimester of pregnancy. Amniotic fluid and neonates’ oropharyngeal secretions were collected during delivery. The presence of CT and CP DNA was detected by nested PCR. Results: (1) The positive rate of CT in cervical secretions was significantly higher than that in normal pregnancy (14.0% vs 3.2%, P <0.01). The positive rates of CP in the intrauterine growth retardation group (11.1%) were higher than those in normal pregnancy 1.1% of the group (P <0.05). (2) The positive rates of CT and CP in amniotic fluid were 28.6% and 60% respectively in cervical positive group, which were significantly higher than those in cervical negative group (P <0.05 and P <0.01). (3) The positive rate of throat swab CT was 36.8% in cervical positive group and 5.6% in cervical negative group (P <0.001). The positive rate of CP was 7.0% in cervical negative group and 0 in positive group. Conclusion: Both CT and CP can cause reproductive tract infection in pregnant women and spread vertically. CT infection in neonates mainly comes from the birth canal, while CP is mainly intrauterine infection. IUGR premature birth, premature rupture of membranes, history of fetal necrosis and chlamydial infection, it is necessary for screening and treatment of pregnant women to block mother-to-child transmission.