正常妊娠羊水板层小体增长特征及临床意义

Investigation of amniotic fluid lamellar body concentration profile and the significance in predicting fetal lung maturity in normal pregnancy

目的:探讨羊水板层小体数量在正常妊娠时的增长规律及其对判断胎肺成熟度的意义。方法:测量302份正常单胎妊娠24～41周的羊水板层小体数目,其中33例为采集两次羊水,并在第一次穿刺时羊膜腔内注射地塞米松10 mg。结果:妊娠24～31周羊水中板层小体一直处于相对较低的数值,妊娠32周后,羊水板层小体数目增长速度开始逐渐加快,至妊娠35周,LBC已达到35×109/L。另外,将LBC与取材孕周做曲线拟和显示LBC与孕周呈指数相关,相关系数(r)为0.938 6,决定系数(r2)为0.881,y=e0.021 8+0.253 1x,显著性检验:P<0.001,差异具有统计学意义。33例收集两次羊水的孕妇,使用地塞米松前羊水的LBC平均值为(21+2.9)×109/L,使用地塞米松后羊水的LBC值为(56+3.7)×109/L,两组比较差异有统计学意义。结论:正常妊娠羊水板层小体数量随孕周呈指数增长,可利用板层小体数目对孕周的指数模型对胎肺成熟度做判断。

Objective To observe the change regulation of amniotic fluid lamellar body count（LBC） during the normal pregnancy, and to evaluate the value of LBC in fetal lung maturity. Method Measured the quantity of lamellar bodies in 302 samples of amniotic fluid,in which 33 cases were detected for twice after administration of dexamethasone to accelerate fetal pulmonary maturity, and the neonatal out- comes were followed up. Results The quantifies of amniotie fluid lamellar bodies were low before 31 gestational weeks. The increasing speed of LBC added progressively to the 32 gestational week. Lamellar body count was best represented as an exponential curvilinear function of gestation age. Conclusion The number of snmionic fluid LBC increases exponentially as gestation advances in normal pregnancy.