Lamellar Body Count and Stable Microbubble Test on Gastric Aspirates from Preterm Infants for the Diagnosis of Respiratory Distress Syndrome
Lamellar Body Count and Stable Microbubble Test on Gastric Aspirates from Preterm Infants for the Diagnosis of Respiratory Distress Syndrome
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DOI：
10.1159/000279887
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发表时间：
2010-01-01
期刊：
影响因子：
2.5
通讯作者：
Fiori, Renato Machado
中科院分区：
文献类型：
--
作者：
Batista da Silva Daniel, Inah Westphal;Fiori, Humberto Holmer;Fiori, Renato Machado
背景：羊水中的板层体数(LBC)被用来识别有呼吸窘迫综合征(RDS)风险的婴儿，这些婴儿将受益于表面活性物质的预防或非常早期的治疗。对新生儿胃抽吸物的检测还没有得到适当的探索。目的：本研究的主要目的是评价LBC单独或联合稳定微泡试验(SMT)对早产儿胃抽吸物预测RDS的效果。方法：有RDS的早产儿34例，无RDS的早产儿29例，胎龄24~34周。在产房采集胃液。稀释剂(二硫苏糖醇)允许处理所有样品，即使是最厚和不均匀的样品，也不需要离心机。同时进行SMT检查以作对照。结果：L预测RDS的最佳临界值为42000个板层小体/亩，其敏感性为92%(95%可信区间73~100%)，特异性为86%(95%可信区间77~95%)。受试者-工作特征曲线下面积为0.928(95%可信区间为0.86~0.99)。SMT也有类似的结果。LBC和SMT联合检测的敏感性为100%，特异性为86%。结论：胃抽吸物经二硫苏糖醇溶液稀释后行LBC操作简便快捷，可单独或联合SMT作为RDS的预测指标，仅对表面活性物质缺乏的新生儿进行选择性预防或早期治疗。版权所有(C)2010 S.Karger AG，巴塞尔
Background: Lamellar body count (LBC) in amniotic fluid is being used to identify infants at risk of respiratory distress syndrome (RDS) who would benefit from surfactant prophylaxis or very early therapy. The test in gastric aspirates of newborns has not been properly explored. Objective: The main objective of this research was to evaluate the performance of LBC alone or in combination with the stable microbubble test (SMT), done on gastric aspirates from preterm babies to predict RDS. Methods: A total of 34 preterm infants with RDS and 29 without RDS, with a gestational age between 24 and 34 weeks, were included in the study. Gastric fluid was collected in the delivery room. A diluent (dithiothreitol) allowed all samples to be processed, even the thickest and non-homogeneous ones, without centrifugation. The SMT was done for comparison. Results: The best cut-off value was ! 42,000 lamellar bodies/mu l to predict RDS, with a sensitivity of 92% (95% CI 73-100%) and specificity of 86% (95% CI 77-95%). The area under the receiver-operating characteristic curve was 0.928 (95% CI 0.86-0.99). SMT showed similar results. LBC and SMT together in series (positive result if both tests were positive) showed a sensitivity of 100% and a specificity of 86%. Conclusion: LBC on gastric aspirates diluted in a solution of dithiothreitol can be rapidly and easily performed, and may be used alone or in combination with SMT as a predictor of RDS, allowing selective prophylaxis or very early treatment only in surfactant-deficient newborns. Copyright (C) 2010 S. Karger AG, Basel