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板层小体计数在预测非糖尿病孕妇新生儿呼吸窘迫综合征中的作用。

Role of lamellar body count for the prediction of neonatal respiratory distress syndrome in non-diabetic pregnant women.

作者信息

Ghidini Alessandro, Poggi Sarah H, Spong Catherine Y, Goodwin Katie M, Vink Joy, Pezzullo John C

机构信息

Department of Obstetrics and Gynecology, Georgetown University Hospital, 3PHC 3800 Reservoir Road, N.W., Washington, DC 20007, USA.

出版信息

Arch Gynecol Obstet. 2005 Apr;271(4):325-8. doi: 10.1007/s00404-004-0653-7. Epub 2004 Jun 18.

Abstract

OBJECTIVE

Lamellar body count is a new and fast technique to establish the presence of fetal lung maturity. We have assessed the predictive ability of lamellar body count for neonatal respiratory distress syndrome (RDS) in a non-diabetic population.

STUDY DESIGN

We accessed a cohort of amniocenteses in non-diabetic women from 1998 to 2002 (n=102). Neonatal RDS was defined as need for surfactant, intubation, or continuous positive airway pressure (CPAP) in the setting of chest X-ray findings consistent with RDS. The predictive ability of lamellar body count was compared with those of lecithin/sphingomyelin (L/S) ratio and presence of phosphatidylglycerol (PG) using logistic regression analysis. The optimal threshold value of lamellar body count for prediction of neonatal RDS was established with receiver operating characteristic (ROC) curve analysis.

RESULTS

Lamellar body count ROC curve analysis identified a lamellar body count >37,000 microl(-1) as optimal diagnostic threshold for diagnosis of lung maturity, having a negative predictive value of 98%. Lamellar body count and PG, but not L/S ratio, added significantly to the prediction of RDS.

CONCLUSIONS

Lamellar body count is a reliable predictor of fetal lung maturity in non-diabetic women and it can replace the L/S ratio.

摘要

目的

板层小体计数是一种用于确定胎儿肺成熟度的新的快速技术。我们评估了板层小体计数对非糖尿病人群新生儿呼吸窘迫综合征(RDS)的预测能力。

研究设计

我们纳入了1998年至2002年非糖尿病女性羊膜穿刺术队列(n = 102)。新生儿RDS定义为在胸部X线检查结果符合RDS的情况下需要使用表面活性剂、插管或持续气道正压通气(CPAP)。使用逻辑回归分析比较板层小体计数与卵磷脂/鞘磷脂(L/S)比值和磷脂酰甘油(PG)的预测能力。通过受试者工作特征(ROC)曲线分析确定预测新生儿RDS的板层小体计数的最佳阈值。

结果

板层小体计数ROC曲线分析确定板层小体计数>37,000 μL⁻¹为诊断肺成熟度的最佳诊断阈值,阴性预测值为98%。板层小体计数和PG,但不是L/S比值,对RDS的预测有显著增加。

结论

板层小体计数是非糖尿病女性胎儿肺成熟度的可靠预测指标,它可以替代L/S比值。

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