羊水板层小体计数预测胎儿肺成熟的可行性及其临床意义

Feasibility and clinical significance of lamellar body count in amniotic fluid for prediction of fetal lung maturity

目的:探讨羊水板层小体计数预测胎肺成熟度的临床应用价值。方法:选择156例单胎孕妇作为研究对象,孕28～38周,每份羊水分3份分别进行LBC计数、L/S比值测定及泡沫试验。结果:羊水LBC与L/S比值成正线性相关,相关系数(r)为0.623,有极显著统计学意义(P<0.001);LBC与泡沫试验呈等级相关,相关系数为(r)为0.781,有极显著统计学意义(P<0.001)。以LBC≤10×109/L作为判断胎儿肺不成熟的临界值,以LBC≥35×109/L作为判断胎儿肺成熟的临界值,比较羊水LBC计数各预测值率与L/S比值差异无统计学意义(P>0.05);与泡沫试验相比,羊水LBC计数的各预测值明显高于泡沫试验,差异有统计学意义(P<0.01)。结论:羊水LBC计数在预测胎肺成熟度方面优于传统的泡沫试验,较L/S比值省时、省力,是临床中用于判断胎儿肺成熟方法的首选。

Objective：To explore the clinical application value of lamellar body count in amniotic fluid for prediction of fetal lung maturity.Methods：A total of 156 single pregnant women were selected as study objects,the amniotic fluid samples underwent LBC count,L/S detection,and foam test simultaneously during 28-38 gestational weeks.Results：There was a positive linear correlation between LBC count and L/S ratio（γ=0.623,P〈0.001）;there was a rank correlation between LBC count and foam test（γ=0.781,P〈0.001）;LBC≤10×109/L and LBC≥35×109/L were designed as critical values to predict fetal lung immaturity and fetal lung maturity,respectively,there was no significant difference in the predictive values between LBC count and L/S ratio（P〉0.05）;the predictive values of LBC count was significantly higher than those of foam test（P〈0.01）.Conclusion：Amnionic fluid LBC count is superior to routine foam test for prediction of fetal lung maturity;compared with L/S ratio,the method is time-saving and labor-saving,and it is the first choice to predict fetal lung maturity in clinic.