Lorenz U, Weitzel H K, Ragosch V, Gips H
Frauenklinik Klinikum Steglitz der Freien Universität Berlin.
Z Geburtshilfe Perinatol. 1988 Jan-Feb;192(1):1-6.
Two currently used methods of determining fetal pulmonary maturity were verified on the basis of 148 amniotic fluid samples: one dimensional sequential thin-layer chromatographic determination of the lecithin: sphingomyelin ratio and of phosphatidyl glycerol, and an immunologic slide detection of phosphatidyl glycerol (Amniostat-FLM). With both methods, which have the advantage that they can be performed quickly and can sometimes even be used at the bedside (Amniostat-FLM), a respiratory distress syndrome in the newborn can be ruled out with a high degree of confidence if the threshold values are exceeded (L/S greater than 2; phosphatidyl glycerol present). As with all historical methods, the positive correctness of these two modern methods (no RDS if the child is born within 72 hours despite a negative phosphatidyl glycerol test in the amniotic fluid) is low. Clearly, apart from the quantitative existence of certain surfactant phospholipids (lecithin, phosphatidyl glycerol), there are other perinatal events or measures which determine the extent and severity of RDS in the immature newborn.
基于148份羊水样本,对目前使用的两种测定胎儿肺成熟度的方法进行了验证:一种是通过一维连续薄层色谱法测定卵磷脂与鞘磷脂的比值以及磷脂酰甘油,另一种是通过免疫玻片检测磷脂酰甘油(羊水胎儿肺成熟度检测试剂盒)。这两种方法都具有能够快速进行,有时甚至可以在床边使用(羊水胎儿肺成熟度检测试剂盒)的优点。如果超过阈值(卵磷脂/鞘磷脂大于2;存在磷脂酰甘油),则可以高度确定地排除新生儿呼吸窘迫综合征。与所有传统方法一样,这两种现代方法的阳性正确性较低(如果尽管羊水磷脂酰甘油检测呈阴性,但婴儿在72小时内出生,则无呼吸窘迫综合征)。显然,除了某些表面活性物质磷脂(卵磷脂、磷脂酰甘油)的定量存在外,还有其他围产期事件或措施决定了未成熟新生儿呼吸窘迫综合征的程度和严重程度。