羊水板层小体计数预测胎肺生化成熟

目的:探讨羊水板层小体计数(LBC)诊断胎肺生化成熟的价值。方法:测定118例妊娠≥28周羊水标本的LBC,用ROC曲线分析LBC诊断L/S比值、磷脂酰甘油(PG)成熟的界值和价值。结果:LBC与L/S比值、PG、泡沫试验、OD 650密切相关(P<0.001);LBC诊断L/S比值≥2.0或PG阳性的ROC曲线下面积为0.959(95%C I=0.929~0.989),最佳界值为≥86×109/L,诊断L/S比值<2.0及PG阴性的最佳界值为<40×109/L;LBC以≥86×109/L为界,诊断胎肺生化成熟的灵敏度为81.08%,特异度为100%,阳性预测价值100%,阴性预测价值为75.86%;以≥40×109/L为界,其灵敏度为100%,阴性预测价值为100%。结论:羊水板层小体计数对胎肺生化成熟有较高的诊断价值,可作为首选的胎肺成熟度快速筛选试验。

Investigation of lamellar body count in amniotic fluid for prediction of biochemical fetal lung maturity

Objective:To determine the value of lamellar body count(LBC) in amniotic fluid(AF) to predict the biochemical fetal lung maturity.Methods:LBC were performed in 118 AF samples,the cutoff value of LBC for predicting positive L/S ratio or phosphatidylglycerol(PG) was estimate by ROC curve.Results:LBC versus L/S ratio,PG,foam test and OD650 showed a significant relation.The area under the ROC curve was 0.959(95%C1=0.929~0.989),and the optimal cutoff value of LBC for predicting the L/S ratio≥2.0 or positive PG was ≥86×109/L,while the threshold <40×10 9/L indicated L/S ratio<2.0 and negative PG.When the LBC threshold was ≥86×109/L,the sensitivity for diagnosing biochemical fetal lung maturity was found to be 81.08%,where specificity 100%,predictive value(PV)(+) 100% and PV(-) 75.86%.At the ≥40×109/L cutoff,the sensitivity was 100%,and PV(-) was 100%.Conclusion:LBC is an effective diagnostic test of biochemical fetal lung maturity,and could be the first choice.