使用孕龄、患者特征和胎儿肺成熟度检测预测胎儿肺不成熟：一种概率方法。
Prediction of fetal lung immaturity using gestational age, patient characteristics and fetal lung maturity tests: a probabilistic approach.
机构信息
Department of Obstetrics, Neonatology and Gynaecology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
出版信息
Arch Gynecol Obstet. 2010 Jan;281(1):15-21. doi: 10.1007/s00404-009-1033-0. Epub 2009 Apr 19.
OBJECTIVES
The lecithin/sphingomyelin (L/S) ratio and the lamellar body count (LBC) can be used to predict respiratory distress syndrome (RDS).
DESIGN
We performed a retrospective cohort study among consecutive women who underwent amniotic fluid sampling for the assessment of fetal lung maturity. Logistic regression was used to construct models for the prediction of RDS in three gestational age categories, with models based on clinical characteristics only, clinical characteristics and the LBC, and on clinical characteristics and L/S ratio.
RESULTS
When amniotic fluid was collected <30 weeks, the specificity of the LBC was 30% and the sensitivity 100%. Addition of the L/S ratio increased the specifity to 60%, for a sensitivity of 100%. When amniocentesis was performed between 30 and 33 weeks, addition of the L/S ratio only marginally improved the performance of the LBC.
CONCLUSIONS
At a gestational age <30 weeks, the L/S ratio has additional value over the LBC. Above 30 weeks of gestation, single use of the LBC seems sufficient.
目的
卵磷脂/鞘磷脂（L/S）比值和板层小体计数（LBC）可用于预测呼吸窘迫综合征（RDS）。
设计
我们对连续进行羊水采样以评估胎儿肺成熟度的女性进行了回顾性队列研究。使用逻辑回归为三个不同胎龄组的 RDS 预测构建模型，模型基于仅临床特征、临床特征和 LBC 以及临床特征和 L/S 比值。
结果
当在<30 周时采集羊水时，LBC 的特异性为 30%，敏感性为 100%。添加 L/S 比值可将特异性提高到 60%，而敏感性为 100%。当在 30 周到 33 周之间进行羊膜穿刺术时，添加 L/S 比值仅略微改善了 LBC 的性能。
结论
在<30 孕周时，L/S 比值比 LBC 具有额外的价值。在 30 周以上的妊娠中，单独使用 LBC 似乎足够了。
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