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中华医学超声杂志(电子版) ›› 2022, Vol. 19 ›› Issue (05) : 385 -390. doi: 10.3877/cma.j.issn.1672-6448.2022.05.001

所属专题: 总编推荐 指南共识

指南与规范

《超声在先天性感染中的临床应用指南(2020)》要点解读
周凡1, 王和1,()   
  1. 1. 610041 成都,四川大学华西第二医院医学遗传科/产前诊断中心、出生缺陷与相关妇儿疾病教育部重点实验室
  • 收稿日期:2020-12-12 出版日期:2022-05-01
  • 通信作者: 王和

Interpretation of ISUOG Practice Guidelines: role of ultrasound in congenital infection

Fan Zhou1, He Wang1()   

  • Received:2020-12-12 Published:2022-05-01
  • Corresponding author: He Wang
引用本文:

周凡, 王和. 《超声在先天性感染中的临床应用指南(2020)》要点解读[J]. 中华医学超声杂志(电子版), 2022, 19(05): 385-390.

Fan Zhou, He Wang. Interpretation of ISUOG Practice Guidelines: role of ultrasound in congenital infection[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(05): 385-390.

表1 妊娠期孕妇病原体血清学检测结果与临床推荐
IgM IgG 临床推荐
阴性 阴性 对无临床症状及无接触史者,无妊娠期感染的证据;可疑感染B19者,4周后复查血清学抗体,若IgM或IgG阳性,需密切监测胎儿出现B19感染的可能
阴性 阳性

CMV及RV:无临床症状、无接触史者,既往感染或接种风疹疫苗后获得免疫

Toxo:妊娠早中期检出者,提示孕前感染可能;妊娠晚期检出者,结果解释困难,可能为孕前感染,或孕早期感染后Toxo IgM已阴转

B19:既往感染及已有免疫,胎儿宫内感染风险低

阳性或可疑 阴性

CMV及Toxo:建议2~3周后复查,若IgG转阳,原发感染可能性大;若IgG抗体未转阳,非急性感染或IgM假阳性可能性大

RV:建议5~10 d后复查,若IgG转阳,原发感染可能性大,若IgG抗体未转阳,IgM假阳性可能性大

B19:密切监护胎儿可能出现B19感染的可能

阳性或可疑 阳性

CMV:建议2~4周后复查,若抗体滴度无显著变化,考虑非急性感染IgM假阳性或持续阳性;若抗体滴度变化显著,建议检测IgG亲和力

Toxo:建议2~3周后复查,同时行IgG亲和力检测,若抗体水平无明显变化,应将2次血样送至Toxo实验室行特异性确诊实验1

RV:建议5~10 d后复查,若抗体滴度无显著变化,非急性感染可能性大;若抗体滴度显著变化,急性感染可能性大

B19:对明确感染症状前的血样进行IgM和IgG检测,若结果阴性,可确定感染及感染时机;密切监护胎儿可能出现B19感染的可能

表2 妊娠期孕妇病原体IgG亲和力与感染时机
表3 妊娠期病原体感染者胎儿宫内感染的风险
表4 胎儿宫内病原体感染相关的超声异常
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