Sher G, Statland B E, Knutzen V K
J Reprod Med. 1982 Feb;27(2):51-5.
We analyzed 331 pregnancies where clear, uncontaminated amniotic fluid was obtained within 72 hours of delivery from both normal and complicated gestations. There were 43 cases of the neonatal idiopathic respiratory distress syndrome (IRDS), 42 of which were associated with foam stability index (FSI) values of less than 0.47. In 276 of the 323 cases sufficient amniotic fluid was available to permit concurrent performance of the lecithin/sphingomyelin ratio (L/S) assay. Thirty-five cases of IRDS occurred in this group, 8 of which were associated with L/S ratio values greater than 2.0. The risk of IRDS occurrence was calculated for three groups of FSI values (shown in parentheses below). They were as follows: group I--FSI values less than or equal to 0.43 (73%); group II--FSI values of 0.44 to 0.46 (29.2%); group III--FSI values greater than or equal to 0.47 (0.35%). Comparable evaluations for the L/S ratio procedure showed the FSI test to be significantly more specific and sensitive than the L/S ratio assay. The improved performance of the FSI test was most marked in pregnancies complicated by insulin-dependent diabetes mellitus and intrauterine growth retardation. The low cost, ease and rapidity of the FSI test, as well as the fact that it does not require sophisticated technical equipment or expertise, makes this sensitive and specific assay a method of choice for the prenatal evaluation of fetal pulmonary maturity.
我们分析了331例妊娠病例，这些病例在分娩后72小时内获取了清亮、未受污染的羊水，涵盖正常妊娠和复杂妊娠。其中有43例新生儿特发性呼吸窘迫综合征（IRDS），其中42例与泡沫稳定指数（FSI）值低于0.47有关。在323例中的276例中，有足够的羊水可用于同时进行卵磷脂/鞘磷脂比值（L/S）测定。该组中有35例发生IRDS，其中8例与L/S比值大于2.0有关。针对三组FSI值（如下括号所示）计算了IRDS发生的风险。具体如下：第一组——FSI值小于或等于0.43（73%）；第二组——FSI值为0.44至0.46（29.2%）；第三组——FSI值大于或等于0.47（0.35%）。对L/S比值测定方法的类似评估表明，FSI检测比L/S比值测定更具特异性和敏感性。FSI检测性能的改善在合并胰岛素依赖型糖尿病和宫内生长迟缓的妊娠中最为明显。FSI检测成本低、操作简便、快速，且不需要复杂的技术设备或专业知识，这使得这种灵敏且特异的检测方法成为产前评估胎儿肺成熟度的首选方法。
