羊水板层小体计数对预测早产儿肺成熟度的价值研究

【目的】 探讨板层小体对预测早产儿肺成熟度的临床价值。 【方法】 对早产儿进行板层小体计数,找出反应肺成熟度的判定界值,并统计其对肺成熟度的阳性预测值、阴性预测值、敏感性、特异性以及对34周以下早产儿的预测情况。 【结果】 成熟判定界值≥98 000/μL时其阴性预测值100%;阳性预测值 27.1%;敏感性100%;特异性41.9%;34周以下早产儿的阴性预测值100%,阳性预测值53.6%,敏感性100%,特异性23.5%,可以避免23.5%早产儿气管插管和使用PS;不成熟判定界值≤33 000/μL时阴性预测值96.7%;阳性预测值46.7%;敏感性87.5%;特异性78.4%;34周以下早产儿的阴性预测值85.7%,阳性预测值72%,敏感性100%,特异性70.6%;可使70.6%的早产儿避免气管插管和肺表面活性物质使用;33 000~98 000/μL之间为可疑值时此范围的发病率为20%。 【结论】 板层小体的计数对于预测新生儿肺成熟度是一个较好的筛选试验。

Study of the amniotic fluid lamellar body count about prediction in preterm infants lung maturity

【Objectives】 To discuss the clinical value of the lamellar bodies,and to estimate the preterm infants lung maturity.【Methods】 The lamellar body count of preterm infants was examined for finding the best cut-off value,the positive predictive value,negative predictive value,sensitivity,specificity of lung maturity,especially in gestational age less than 34 weeks.【Results】 The best cut-off value was ≥98 000/μL lamellar bodies to predict the lung maturity,with a positive predictive value of 27.1%,negative predictive value of 100%,sensitivity of 100% and specificity of 41.9%.With a positive predictive value of 53.6%,negative predictive value of 100%,sensitivity of 100% and specificity of 23.5% in preterm infants with gestational age less than 34 weeks.23.5% of preterm infants could avoid intubation and use of the surfactant.The best cut-off value was ≤33 000/μL lamellar bodies to predict the lung immaturity,with a positive predictive value of 46.7.8%,negative predictive value of 96.7%,sensitivity of 87.5% and specificity of 78.4%.With a positive predictive value of 72%,negative predictive value of 85.7%,sensitivity of 86.7% and specificity of 70.6% in preterm infants with gestational age less than 34 weeks.70.6% of preterm infants could avoid intubation and use of the surfactant.The incidence of RDS was 20% if the suspicious value between 33 000~98 000/μL lamellar bodies.【Conclusion】 Lamellar body count is a good screening test for predicting the degree of neonatal lung maturity.