不同胎龄新生儿胃液卵磷脂／鞘磷脂比值变化及其临床意义

ALTERATIONS AND CLINICAL SIGNIFI-CANCE OF THE GASTRIC ASPIRATELECITHIN/SPHINGOMYELIN RATIO iNNEWBORNS WITH DIFFERENT GESTA-TIONAL AGE

应用薄层层析法检测１１０例［足月儿５０例，其中正常新生儿３０例，窒息１２例，妊娠高血压综合征（简称好高征）母亲所生新生儿８例；早产儿６０例］新生儿胃液卵磷脂／鞘磷脂（Ｌ／Ｓ）比值。结果显示，足月儿Ｌ／Ｓ比值＞２．０，早产儿＜２．０，早产儿Ｌ／Ｓ比值与胎龄、体重有非常显著正相关（ｒ分别为０．８６、０．６５，Ｐ均＜０．０１）。足月窒息儿Ｌ／Ｓ比值明显低于正常对照组（ｔ＝２．６０，Ｐ＜０．０５）；患妊高征母亲所生新生儿Ｌ／Ｓ比值明显高于对照组（ｔ＝３．０３，Ｐ＜０．０１），提示母亲患妊高征有使胎儿肺成熟加速的倾向。６０例早产儿并发呼吸窘迫综合征７例，Ｌ／Ｓ比值均在１．０９以下，５例死亡，其中４例Ｌ／Ｓ比值在０．４以下。提示胃液Ｌ／Ｓ比值对评价肺成熟度及预估呼吸窘迫综合征发生及预后有重要参考价值。

astric aspirate Lecithin/Sphingomyelins ( L/S )ratio was measured in 110 newborns with different ges-tational age by thin-layer chroma-tography. The gastricaspirate L/S ratio obtained from mature infants washigher than 2. 0 and that from premature infants waslower than 2. 0. In premature infants, there were sig-nificantly positive correlations between L/S ratio andgestational age (r= 0. 87, P<0. 01) and body weight(r = 0. 65, P < 0. 01 ) , respectively. L/S ratio waslower in infants with asphyxia than that in the normalsubjects (t= 2. 60, P<0. 05) and it was signifi cantlyincreased in neonates born to mothers with toxemia ofpregnancy compared with normal infants (t=3. 30,P<0. 01). Seven of 60 premature infants complicatedwith RDS, of whom, 5 dead , whose L/S ratio were be-low 0. 4. We conclude that the gastric aspirate L/S ratiomay be one of the predictors for fetal lung maturity andthe severity of RDS.