van den Berg W, Breederveld C, ten Cate J W, Peters M, Borm J J
Division of Haemostasis and Thrombosis, University of Amsterdam, The Netherlands.
Eur J Pediatr. 1989 Feb;148(5):455-8. doi: 10.1007/BF00595913.
A prospective study was performed in premature neonates to determine the predictive values of antithrombin III (AT III) deficiency immediately after birth, for the subsequent development of idiopathic respiratory distress syndrome (IRDS), intraventricular haemorrhage (IVH) and death. Of the 81 premature infants studied, 24 developed IRDS (30%). Of these 24 premature infants, 8 also developed IVH and 9 infants died within the follow-up period of 7 days. The mean plasma AT III level was significantly lower in the infants developing IRDS (0.23 U/ml vs 0.35 U/ml, P less than 0.0005). Within this study group 33 neonates of less than 30 weeks' gestation showed a prevalence for IRDS of 48%. In this group, AT III activity levels below 0.30 U/ml were 8.5 times as likely to result from infants with IRDS than from infants without IRDS. The diagnostic accuracy indices of criteria for the development of IRDS were: a sensitivity of 100%, a specificity of 88%, a positive predictive value of 89% and a negative predictive value of 100%. The predictive values for the development of IVH and occurrence of death were insignificant. Therefore, in premature neonates the combination of less than 30 weeks' gestation and an AT III below 0.30 U/ml is highly suggestive of IRDS and may facilitate the evaluation of early treatment.
对早产儿进行了一项前瞻性研究，以确定出生后即刻抗凝血酶III（AT III）缺乏对特发性呼吸窘迫综合征（IRDS）、脑室内出血（IVH）及死亡后续发生情况的预测价值。在研究的81例早产儿中，24例发生了IRDS（30%）。在这24例早产儿中，8例还发生了IVH，9例在7天的随访期内死亡。发生IRDS的婴儿血浆AT III平均水平显著更低（0.23 U/ml对0.35 U/ml，P<0.0005）。在该研究组中，33例孕周小于30周的新生儿IRDS患病率为48%。在该组中，AT III活性水平低于0.30 U/ml的婴儿发生IRDS的可能性是未发生IRDS婴儿的8.5倍。IRDS发生标准的诊断准确性指标为：敏感性100%，特异性88%，阳性预测值89%，阴性预测值100%。IVH发生及死亡的预测价值不显著。因此，在早产儿中，孕周小于30周且AT III低于0.30 U/ml高度提示IRDS，可能有助于早期治疗评估。
