【目的】 探讨板层小体对预测早产儿肺成熟度的临床价值。 【方法】 对早产儿进行板层小体计数,找出反应肺成熟度的判定界值,并统计其对肺成熟度的阳性预测值、阴性预测值、敏感性、特异性以及对34周以下早产儿的预测情况。 【结果】 成熟判定界值≥98 000/μL时其阴性预测值100%;阳性预测值 27.1%;敏感性100%;特异性41.9%;34周以下早产儿的阴性预测值100%,阳性预测值53.6%,敏感性100%,特异性23.5%,可以避免23.5%早产儿气管插管和使用PS;不成熟判定界值≤33 000/μL时阴性预测值96.7%;阳性预测值46.7%;敏感性87.5%;特异性78.4%;34周以下早产儿的阴性预测值85.7%,阳性预测值72%,敏感性100%,特异性70.6%;可使70.6%的早产儿避免气管插管和肺表面活性物质使用;33 000~98 000/μL之间为可疑值时此范围的发病率为20%。 【结论】 板层小体的计数对于预测新生儿肺成熟度是一个较好的筛选试验。

【Objectives】 To discuss the clinical value of the lamellar bodies,and to estimate the preterm infants lung maturity. 【Methods】 The lamellar body count of preterm infants was examined for finding the best cut-off value,the positive predictive value,negative predictive value,sensitivity,specificity of lung maturity,especially in gestational age less than 34 weeks. 【Results】 The best cut-off value was ≥98 000/μL lamellar bodies to predict the lung maturity,with a positive predictive value of 27.1%,negative predictive value of 100%,sensitivity of 100% and specificity of 41.9%.With a positive predictive value of 53.6%,negative predictive value of 100%,sensitivity of 100% and specificity of 23.5% in preterm infants with gestational age less than 34 weeks.23.5% of preterm infants could avoid intubation and use of the surfactant.The best cut-off value was ≤33 000/μL lamellar bodies to predict the lung immaturity,with a positive predictive value of 46.7.8%,negative predictive value of 96.7%,sensitivity of 87.5% and specificity of 78.4%.With a positive predictive value of 72%,negative predictive value of 85.7%,sensitivity of 86.7% and specificity of 70.6% in preterm infants with gestational age less than 34 weeks.70.6% of preterm infants could avoid intubation and use of the surfactant.The incidence of RDS was 20% if the suspicious value between 33 000~98 000/μL lamellar bodies. 【Conclusion】 Lamellar body count is a good screening test for predicting the degree of neonatal lung maturity.