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目的 探讨超声联合试验室检查对胎儿宫内 TORCH感染的诊断价值.方法 回顾性分析2013年5月-2016年8月在医院接受孕检的孕妇临床资料,所有孕妇均采用酶联免疫吸附法对其血清 TORCH特异性抗体进行检测,同时接受超声检查观察胎儿发育情况,观察试验室检查诊断胎儿宫内 TORCH感染的准确性,分析超声对宫内感染胎儿发育的预测价值.结果 110名胎儿中,确诊发生宫内 TORCH 感染者18例,感染率为16.36%;110名孕妇中,血清抗TORCH IgM 抗体阳性20例,阳性率18.18%;感染孕妇血清IL-6、IL-8、T NF-α、CRP和IgM水平均高于未感染孕妇(P<0.001);血清IL-6、IL-8、TNF-α、CRP和IgM 水平对胎儿宫内 TORCH感染诊断的灵敏度为82.5%、84.9%、75.3%、68.7%、80.2% 特异度为80.3%、78.5%、70.1%、73.2%、78.8%,诊断指数159.3%、165.2%、142.6%、135.2%、160.5%;通过超声对确诊为宫内 TORCH感染胎儿进行诊断,发现发生胎儿发育异常者4例,其中包括脐膨出1例,单脐动脉肾盂积水1例,发育迟缓2例,与胎儿出生后诊断结果一致.结论 IL-6、IL-8、TNF-α、CRP和IgM水平对胎儿宫内TORCH感染有较好的诊断价值,且结合超声影像学结果可预测胎儿的发育情况,具有良好的临床应用价值.“,”OBJECTIVE To explore the value of ultrasound combined with laboratory examination in diagnosis of in-trauterine fetal TORCH infectioins.METHODS The clinical data of the pregnant women who received pre-pregnan-cy checks in hospitals from May 2013 to Aug 2016 were retrospectively analyzed.The serum TORCH specific an-tibodies of the pregnant women were detected by using enzyme-linked immunosorbent assay,meanwhile,the fetal development was observed through ultrasound examination,the accuracy of laboratory examination in diagnosis of the intrauterine fetal TORCH infections was observed,and the value of ultrasound in prediction of development of fetuses with infections was analyzed.RESULTS Of 110 fetuses,18 were diagnosed with intrauterine TORCH infec-tions,with the infection rate 16.36%.Among the 110 pregnant women,20 were positive for the serum TORCH IgM antibody,with the positive rate 18.18%.The levels of serum IL-6,IL-8,TNF-α,CRP and IgM of the preg-nant women with infection were higher than those of the pregnant women without infection(P<0.001).The sen-sitivities of the serum IL-6,IL-8,TNF-α,CRP and IgM were respectively 82.5%,84.9%,75.3%,68.7% and 80.2% in diagnosis of the intrauterine fetal TORCH infections;the specificities were respectively 80.3%,78. 5%,70.1%,73.2% and 78.8%;the diagnosis indexes were respectively 159.3%,165.2%,142.6%,135.2%and 160.5%.The ultrasound examination results showed that among the fetuses diagnosed with intrauterine TORCH infections,4 were fetal abnormalities,including 1 case of omphalocele,1 case of single umbilical artery hydronephrosis and 2 cases of growth retardation,which were consistent with the diagnosis results after the birth of the fetuses.CONCLUSION The IL-6,IL-8,TNF-α,CRP and IgM have high value in diagnosis of the intrauterine fetal TORCH infection,and its combination with the ultrasound imaging can predict the fetal develop-ment,which has high clinical application value.