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目的了解河北省隆化地区异常妊娠结局孕妇弓形虫感染状况。方法选择2013-1-2016-6隆化县妇幼保健院就诊的异常妊娠结局孕妇393例为调查对象,根据检测结果分为急性感染组、既往感染组和活动性感染组,正常对照组为无异常妊娠史的孕妇256例。采用酶联免疫吸附实验检测各组孕妇血清弓形虫IgM、IgG抗体。采用问卷调查方式对各组孕妇进行弓形虫感染危险因素调查。结果异常妊娠结局孕妇弓形虫感染率为27.23%(107/393),显著高于正常对照组的8.20%(21/256),差异有统计学意义(χ~2=35.46,P<0.01)。异常妊娠结局孕妇急性感染率为6.87%(27/393)、既往感染率为18.58%(73/393)、活动性感染率为2.54%(10/393),分别高于正常对照组的1.17%(3/256)、7.03%(18/256)和0(0/256),差异均有统计学意义(χ~2=11.43、17.15、7.90,P均<0.01)。感染组中从事接触生肉的职业、饲养猫狗宠物、品尝生肉馅、菜板生熟不分、常吃涮锅或烧烤、经常在外就餐的比例显著高于非感染组,差异均有统计学意义(χ2=12.08、29.23、8.55、13.41、7.28、6.06,P均<0.05)。结论本地区异常妊娠结局孕妇弓形虫感染率较高,避免与宠物密切接触、不食用未煮熟的肉类以及加强个人卫生防护等是避免弓形虫感染的重要环节。
Objective To understand the prevalence of Toxoplasma gondii in pregnant women with abnormal pregnancy outcome in Longhua, Hebei Province. Methods A total of 393 pregnant women with abnormal pregnancy outcomes at the Maternal and Child Health Care Hospital of Longhua County from January 2013 to June 2016 were enrolled and divided into acute infection group, 256 pregnant women with abnormal pregnancy history. Serum Toxoplasma gondii IgM and IgG antibodies were detected by enzyme-linked immunosorbent assay. Questionnaire survey on pregnant women in each group of Toxoplasma infection risk factors. Results Toxoplasma infection rate in pregnant women with abnormal pregnancy outcome was 27.23% (107/393), significantly higher than that of the control group (8.20%, 21/256). The difference was statistically significant (χ ~ 2 = 35.46, P <0.01). The rate of acute infection in pregnant women with abnormal pregnancy was 6.87% (27/393), the previous infection rate was 18.58% (73/393) and the active infection rate was 2.54% (10/393), which were 1.17% (3/256), 7.03% (18/256) and 0 (0/256), respectively. The difference was statistically significant (χ ~ 2 = 11.43,17.15,7.90, P <0.01). The infected group engaged in the contact with raw meat, pets, cats and dogs, raw meat, chopping board or barbecue, often out of dining was significantly higher than the proportion of non-infected group, the difference was statistically significant (χ2 = 12.08, 29.23, 8.55, 13.41, 7.28, 6.06, P <0.05). Conclusion The prevalence of Toxoplasma infection in pregnant women with abnormal pregnancy outcomes in the region is high, avoiding close contact with pets, eating undercooked meat and strengthening personal hygiene protection are important links to avoid Toxoplasma gondii infection.