Winn-McMillan Tamina, Karon Brad S
Department of Pathology, Sunrise Hospital and Medical Center, Las Vegas, NV, USA.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 1):778-82. doi: 10.1016/j.ajog.2005.01.045.
We evaluated the usefulness of the TDx-FLM II and lecithin to sphingomyelin (L/S) ratio assays in predicting fetal lung maturity.
We retrospectively reviewed 218 consecutive paired TDx-FLM II and L/S ratio results. Women who delivered viable infants within 72 hours of amniotic fluid collection (n=109) were included in the analysis of sensitivity and specificity. Concordance between tests was determined for all women tested during the study period, and in the subset of women who delivered viable infants within 72 hours of amniotic fluid collection.
There were 9 respiratory distress syndrome (RDS)-affected infants born during the study period. Both the TDx-FLM II and L/S ratios had 100% sensitivity in detecting RDS at their best apparent cut-offs. There was a trend towards increased specificity of the L/S ratio compared with the TDx-FLM II (80% for L/S vs 73% for FLM II). The overall concordance between the TDx-FLM II and L/S ratio was approximately 75%.
The TDx-FLM II and L/S ratios are both sensitive tests for RDS; however, there is not good concordance between the two. The results provide new insight into the optimal use, in sequential or reflex cascade testing, of the TDx-FLM II and L/S ratio.
我们评估了TDx-FLM II和卵磷脂与鞘磷脂（L/S）比值测定在预测胎儿肺成熟度方面的实用性。
我们回顾性分析了连续218对TDx-FLM II和L/S比值的结果。在羊水采集后72小时内分娩出活婴的妇女（n = 109）被纳入敏感性和特异性分析。在研究期间对所有接受检测的妇女，以及在羊水采集后72小时内分娩出活婴的妇女亚组中，确定了两种检测方法之间的一致性。
在研究期间有9名婴儿患呼吸窘迫综合征（RDS）。在各自最佳明显临界值时，TDx-FLM II和L/S比值检测RDS的敏感性均为100%。与TDx-FLM II相比，L/S比值的特异性有增加的趋势（L/S为80%，FLM II为73%）。TDx-FLM II和L/S比值之间的总体一致性约为75%。
TDx-FLM II和L/S比值对RDS都是敏感的检测方法；然而，两者之间的一致性不佳。这些结果为TDx-FLM II和L/S比值在序贯或反射级联检测中的最佳应用提供了新的见解。
