D'Costa M, Dassin R, Bryan H
Department of Clinical Biochemistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
Pediatr Res. 1987 Aug;22(2):154-7. doi: 10.1203/00006450-198708000-00010.
A sensitive and rapid high-performance liquid chromatography method for determining lecithin/sphingomyelin (L/S) ratios in small volume tracheal aspirates has been evaluated in 115 infants sampled within 3 h of delivery. Respiratory distress syndrome was present in 41 infants and all had L/S ratios of less than or equal to 15 (sensitivity 100%). Respiratory distress syndrome was absent in 74 infants, 67 of whom had L/S ratios of greater than 15 (specificity 91%). Serial tracheal aspirates (n = 68) in 27 infants showed little change in nine respiratory distress syndrome infants with L/S ratio less than or equal to 15 over 3 h while 18 nonrespiratory distress syndrome infants with L/S greater than 15 were more variable. In two infants initial immature ratios rose to maturity rapidly after birth. Comparison of amniotic fluid L/S ratios obtained within 2 h of delivery correlated with the corresponding tracheal aspirate L/S in 24 infants (r = 0.81, p less than 0.001) although the latter were three times higher. This method may have potential routine application in the assessment of surfactant replacement and mechanical ventilator therapies.
一种用于测定小容量气管吸出物中卵磷脂/鞘磷脂（L/S）比值的灵敏且快速的高效液相色谱法，已在115例出生后3小时内采样的婴儿中进行了评估。41例婴儿患有呼吸窘迫综合征，所有患儿的L/S比值均小于或等于1.5（敏感性100%）。74例婴儿未患呼吸窘迫综合征，其中67例的L/S比值大于1.5（特异性91%）。27例婴儿的系列气管吸出物（n = 68）显示，9例L/S比值小于或等于1.5的呼吸窘迫综合征婴儿在3小时内变化不大，而18例L/S大于1.5的非呼吸窘迫综合征婴儿变化更大。2例婴儿出生后初始不成熟的比值迅速升至成熟水平。分娩后2小时内获得的羊水L/S比值与相应气管吸出物L/S比值在24例婴儿中具有相关性（r = 0.81，p < 0.001），尽管后者高出三倍。该方法在评估表面活性剂替代疗法和机械通气治疗方面可能具有潜在的常规应用价值。
