Barkai G, Mashiach S, Modan M, Serr D M, Lanir D, Lusky A, Goldman B, Shinitzky M
Clin Chem. 1983 Feb;29(2):264-7.
Determination of fetal lung maturity by measurement of the fluorescence polarization (P) value of the amniotic fluid at room temperature has become the method of choice in an increasing number of perinatal units because of its simplicity and relatively high predictive value. Nevertheless, its power to discriminate between cases with and without hyaline membrane disease (HMD) needs improvement. To this end, we assessed the discriminative power of the P value at the physiological temperature of 37 degrees C (P37) as compared with the power at 25 degrees C (P25). The study group consisted of 288 consecutive cases at risk for preterm delivery. Samples from all 288 cases were measured at 25 degrees C and samples from 112 of these were measured concurrently at 37 degrees C as well. HMD occurred in 27 infants of the total group, nine of whom belonged to the subgroup tested at both temperatures. When sensitivity was fixed at 100% the specificity of P37 was 97% as compared to 79% for P25 (p less than 0.001). The percentage of cases with infants free of HMD who had borderline P values was also significantly smaller: 1% vs 21%, respectively (p less than 0.001). Although data on more HMD cases are needed to establish the precise threshold of lung maturity for P37, we conclude that P37 is a considerably better discriminator for fetal lung maturity determination than P25.
通过测量室温下羊水的荧光偏振（P）值来确定胎儿肺成熟度，因其操作简单且预测价值相对较高，已在越来越多的围产医学单位成为首选方法。然而，其区分有无透明膜病（HMD）病例的能力仍需改进。为此，我们评估了37摄氏度生理温度下P值（P37）与25摄氏度下P值（P25）的区分能力。研究组由288例连续的早产风险病例组成。所有288例病例的样本均在25摄氏度下测量，其中112例的样本同时也在37摄氏度下测量。全组中有27例婴儿发生HMD，其中9例属于在两个温度下都进行检测的亚组。当敏感性固定为100%时，P37的特异性为97%，而P25为79%（p<0.001）。P值处于临界值但婴儿无HMD的病例百分比也显著更低：分别为1%和21%（p<0.001）。尽管需要更多HMD病例的数据来确定P37的肺成熟度精确阈值，但我们得出结论，与P25相比，P37在确定胎儿肺成熟度方面是一个更好的区分指标。
