Visnjevac Jovana, Novakov-Mikić Aleksandra, Nikolić Aleksandra, Visnjevac Nemanja
Ginekoloska ordinacija Visnjevac, Novi Sad.
Med Pregl. 2010 Sep-Oct;63(9-10):595-600. doi: 10.2298/mpns1010595v.
Respiratory distress syndrome (RDS) of the newborn infant caused by immaturity of fetal lung is a very serious clinical problem. Surfactant is stored in the form of lamellar bodies. They are secreted into alveolar space and passed into amniotic fluid where they can be found. The similarity of lamellar body size to platelet size permits the use of a standard automated hematologic cell counter to estimate the number of lamellar bodies in amniotic fluid.
We conducted a prospective clinical study from 2005-2006 on amniotic fluid samples. Amniotic fluid samples were collected near delivery by transvaginal amniotomy, amniotomy during Cesarean section and 72 hours before delivery by amniocentesis. A hematology analyzer (Nikon-Kohden) was used to determine the lamellar body counts. After birth of newborns we compared their complete clinical examination results particularly emphasizing the prediction of the method of RDS by lamellar body count. Maximally specific lamellar body cutoffs for maturity and immaturity were determined using ROC curves.
Of 232 amniotic fluid samples which were tested, 112 samples were collected by transvaginal amniotomy, 88 were taken during Cesarean delivery and 32 samples were collected by amniocentesis. The incidence of RDS was 14.6%. ROC curves were used to identify cut points for the test. We found that LBC is a good screening test for predicting fetal lung maturity with the area under the curve of 0.751. LBC cutoff of 42 x 10(3)/microl, with sensitivity of 82.4% and specificity of 64.6%, proved best for predicting fetal lung maturity.
LBC is a good screening test for predicting fetal lung maturity. The advantages of LBC are speed, objectivity, low price, low sample volume required and universal availability.
由胎儿肺不成熟引起的新生儿呼吸窘迫综合征（RDS）是一个非常严重的临床问题。表面活性物质以板层小体的形式储存。它们被分泌到肺泡腔并进入羊水，在羊水中可以被检测到。板层小体大小与血小板大小相似，这使得可以使用标准的自动血液学细胞计数器来估计羊水中板层小体的数量。
我们在2005年至2006年对羊水样本进行了一项前瞻性临床研究。羊水样本在分娩时通过经阴道羊膜穿刺术、剖宫产术中的羊膜穿刺术以及分娩前72小时通过羊膜腔穿刺术收集。使用血液学分析仪（尼康-光电）测定板层小体计数。新生儿出生后，我们比较了他们完整的临床检查结果，特别强调通过板层小体计数预测RDS的方法。使用ROC曲线确定成熟和不成熟的最大特异性板层小体临界值。
在检测的232份羊水样本中，112份通过经阴道羊膜穿刺术收集，88份在剖宫产时采集，32份通过羊膜腔穿刺术收集。RDS的发生率为14.6%。使用ROC曲线确定该检测的切点。我们发现板层小体计数是预测胎儿肺成熟度的良好筛查试验，曲线下面积为0.751。42×10³/微升的板层小体计数临界值，敏感性为82.4%，特异性为64.6%，被证明是预测胎儿肺成熟度的最佳值。
板层小体计数是预测胎儿肺成熟度的良好筛查试验。板层小体计数的优点是速度快、客观、价格低、所需样本量少且普遍可用。
