Lee W, Bell M, Novy M J
Am J Obstet Gynecol. 1980 Jan 1;136(1):60-6. doi: 10.1016/0002-9378(80)90565-7.
We investigated the appearance of pulmonary lamellar bodies (LBs) in human amniotic fluid as a function of fetal age. We also studied their relationship to the lecithin/sphingomyelin (L/S) ratio and to the results of the rapid surfactant test (RST). LBs observed in amniotic fluid generally ranged in diameter from 1.5 to 2.0 mu and were seen as single structures or in clusters. When patients were grouped by gestational age, there was a significant difference (P less than 0.001) in the distribution of amniotic fluid LBs. No LBs were observed in amniotic fluid before 26 weeks' gestation, but 50% of specimens at 28 to 32 weeks' gestation and 85% of specimens at term had LBs. Patients with amniotic fluid LBs had higher L/S ratios and intermediate or mature RST values when compared to patients without LBs, but a statistically significant relationship between the presence of LBs and the L/S ratio or RST was not found. We conclude that qualitative examination of amniotic fluid LB content by conventional electron microscopy is unlikely to reflect fetal lung maturation in a precise manner. However, direct quantification of LBs may provide a more specific index of fetal lung maturity and the risk of respiratory distress syndrome.
我们研究了人羊水肺板层小体（LB）的出现情况与胎龄的关系。我们还研究了它们与卵磷脂/鞘磷脂（L/S）比值以及快速表面活性物质试验（RST）结果之间的关系。在羊水中观察到的LB直径一般在1.5至2.0微米之间，呈单个结构或簇状。当按孕周对患者进行分组时，羊水LB的分布存在显著差异（P<0.001）。在妊娠26周前的羊水中未观察到LB，但在妊娠28至32周的标本中有50%以及足月标本中有85%含有LB。与无LB的患者相比，有羊水LB的患者L/S比值更高，RST值为中等或成熟，但未发现LB的存在与L/S比值或RST之间存在统计学上的显著关系。我们得出结论，通过传统电子显微镜对羊水LB含量进行定性检查不太可能精确反映胎儿肺成熟情况。然而，对LB进行直接定量可能会提供一个更具体的胎儿肺成熟指标以及呼吸窘迫综合征的风险指标。
