羊水板层小体计数预测胎肺生化成熟

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

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≥86×10^9/L,诊断L/S比值〈2.0及PG阴性的最佳界值为〈40×10^9/L;LBC以≥86×10^9/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≥40×10^9/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。

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 019650 showed a significant relation. The area trader 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 × 10^9/L, while the threshold 〈40 × 10^9/L indicated L/S ratio 〈2. 0 and negative PG. When the LBC threshold was ≥86 × 10^9/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 × 10^9/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.