摘要
目的研究羊水板层小体计数在预测胎儿肺成熟时的界值,同时探讨促胎肺成熟治疗对LBC的影响。方法前瞻性收集136例孕妇的147份羊水,其中11人取2次羊水,128人随访新生儿结局。所有羊水均进行了LBC测定,同时比较11例不同孕周两次羊水的LBC结果。结果①羊水LBC有明显的孕周分布特点羊水LBC随孕周增加而增长。②136例新生儿中共发生4例RDS,孕周均<37周。以LBC19×1000/μl为界值,预测NRDS的敏感度100%特异度98.4%阳性预测值66.7%阴性预测值100%。③经促胎儿肺成熟治疗后,LBC有明显增长63.3±48.9比105.9±78.5(×1000/μl),t=-2.86,P=0.0168。结论①羊水LBC用于预测胎儿肺成熟度具有较高的敏感性及特异性。②妊娠34周以后,如果存在胎肺不成熟的证据,可进行促胎肺成熟治疗。
Objective To study the cutoff value of amniotic fluid lamellar body counts in prediction of fetal lung maturity and observe the influence on LBC of antenatal corticosteroid therapy for fetal lung maturation. Methods 147 amniotic fluid obtained from 136 patients who delivered in our hospital were collected to test LBC, 11 patients were tested twice. Neonatal outcomes could be traced in 128 patients who delivered after 28 gestational weeks. Result ① LBC were correlated with gestational age, as the gestational age increased , LBC increased gradually. ②Among the 136 neonates, 4 cases were with NRDS, all gestational age of them were less than 37 weeks.③ If the cutoff value of LBC was less than 19×1000/μl, the sensitivity was 100% ：specificity was 98.4% ：positive predictive value was 66.7% and negative predictive value was 100%. ④ LBC was significantly increased after antenatal corticosteroid therapy for fetal maturation, t = -2.86 ,P =0.0168.Conclusion ① The lamellar body count is a valid, rapid screening test for the determination of biochemical fetal maturity. ②The use of corticosteroid after 34 weeks of gestation is recommended if there is evidence of fetal pulmonary immaturity.
出处
《中国医刊》
CAS
2005年第11期33-35,共3页
Chinese Journal of Medicine
关键词
羊水
板层小体计数
胎儿肺成熟度
amniotic fluid
lamellar body counts
fetal lung maturity
