Farquharson J, Jamieson E C, Berry E, Sutton A, Logan R W
Department of Biochemistry, Royal Hospital for Sick Children, Glasgow, Scotland, UK.
Clin Chim Acta. 1988 Feb 15;171(2-3):175-85. doi: 10.1016/0009-8981(88)90143-x.
We present here a combined, quantitative enzymatic procedure for determining amniotic fluid phosphatidylglycerol and phosphatidylcholine and relate these findings to the assessment of fetal lung maturity. Under the assay conditions described phospholipase C specifically hydrolyses phosphatidylglycerol (PG) and phosphatidylcholine (PC) but not sphingomyelin, precluding the need for removal of sphingomyelin prior to analysis. Solvent extraction of the phospholipids from the amniotic fluid is, however, employed to avoid spurious elevation of PG and PC results by endogenous glycerol and choline. Of 45 amniocentesis fluids examined, 28 yielded detectable PG concentrations (greater than 0.5 mumol/l) and all but three of these exhibited PC concentrations in excess of 10 mumol/l. One case of respiratory distress occurred in an infant of 29 wk gestation with severe intrauterine growth retardation. Of the remaining 17 fluids in which PG was undetected enzymatically (less than or equal to 0.5 mumol/l), 14 also contained PC concentrations less than or equal to 10 mumol/l and all six cases of true respiratory distress syndrome came from within this sub-group. Strong correlations between the PC concentration and the lecithin:sphingomyelin ratio, r = 0.85 (p less than 0.001) and the PC and PG concentrations, r = 0.96 (p less than 0.001) were also found.
我们在此介绍一种联合定量酶法，用于测定羊水磷脂酰甘油和磷脂酰胆碱，并将这些结果与胎儿肺成熟度的评估相关联。在所描述的测定条件下，磷脂酶C特异性水解磷脂酰甘油（PG）和磷脂酰胆碱（PC），但不水解鞘磷脂，因此在分析前无需去除鞘磷脂。然而，采用从羊水中溶剂萃取磷脂的方法，以避免内源性甘油和胆碱导致PG和PC结果出现假性升高。在检测的45份羊水样本中，28份产生了可检测到的PG浓度（大于0.5 μmol/l），其中除3份外，所有样本的PC浓度均超过10 μmol/l。一名妊娠29周、患有严重宫内生长迟缓的婴儿出现了呼吸窘迫。在其余17份酶法检测未检测到PG（小于或等于0.5 μmol/l）的样本中，14份的PC浓度也小于或等于10 μmol/l，所有6例真正的呼吸窘迫综合征病例均来自该亚组。还发现PC浓度与卵磷脂：鞘磷脂比值之间存在强相关性，r = 0.85（p小于0.001），PC与PG浓度之间也存在强相关性，r = 0.96（p小于0.001）。
