ارزش تشخیصی شمارش اجسام لاملار (LBC) در مایع آمنیوتیک در تشخیص ابتلا به سندرم دیسترس تنفسی نوزادان (RDS) در ختم حاملگی در هفته های40-28

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و مامائی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 دانشیار گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دستیار تخصصی گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: سندرم دیسترس تنفسی از علل شایع مرگ و میر دوره نوزادی است و علت آن عدم وجود مقدار کافی سورفاکتانت در بافت ریه جنین می باشد. چندین روش آزمایشگاهی برای تعیین بلوغ ریه جنین وجود دارد. هدف از این مطالعه، انجام تست شمارش اجسام لاملار جهت پیشگویی رسیدگی ریه جنین و ابتلا به سندرم دیسترس تنفسی در ریه نوزادان نارس می باشد.
روش کار: مطالعه کاربردی حاضر از نوع بررسی مقطعی است که به مدت 6 ماه در سال 1392 بر روی 91 نوزاد با سن حاملگی40-28 هفته انجام گردید. برای انجام این مطالعه تست شمارش اجسام لاملار بر روی تمام نوزادان مورد بررسی انجام شد. شمارش اجسام لاملار نیز با استفاده از شمارشگر سلولی مدل Sysmex مدلKX-21 صورت گرفت. از منحنی ROC نیز برای تحلیل نتایج استفاده شد.
نتایج: از 91 مورد، 14 نمونه (4/15%) دارای دیسترس تنفسی بودند. رابطه معنی داری بین شیوع دیسترس تنفسی با سن حاملگی (01/0=P)، جنسیت (05/0=P) و وزن نوزادان (01/0=P) وجود داشت. بهترین نقطه برش در مطالعه ما برای شمارش اجسام لاملار کمتر یا مساوی با 22500 بود. همچنین مقادیر حساسیت، ویژگی، گزارش اخباری مثبت و گزارش اخباری منفی به ترتیب برابر با 7/94%، 100%، 100% و 7/94%، بدست آمد.
نتیجه گیری: شمارش اجسام لاملار، تستی مناسب جهت غربالگری از نظر بررسی بلوغ ریه جنین می باشد و حساسیت و ویژگی مناسبی از نظر تشخیص میزان دیسترس تنفسی دارد.

کلیدواژه‌ها


عنوان مقاله [English]

Evaluation of diagnostic value of lamellar body counts (LBC) in amniotic fluid for diagnosis of neonatal respiratory distress syndrome (RDS) in pregnancy termination at 28-40 gestational weeks

نویسندگان [English]

  • Marzieh Lotfalizadeh 1
  • Nayereh Ghomian 2
  • atieh kalateh 3
1 Associate Professor, Department of Obstetrics and Gynecology, Women's Health Research center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Associate Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Resident of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Respiratory distress syndrome (RDS) due to lack of enough surfactant in fetal lung tissue is one of the common causes of neonatal mortality. There are several laboratory methods to determine the amount of fetal lung surfactant. The purpose of this study is to assess the lamellar body count for prediction of the amount of pulmonary surfactant for diagnosis of neonatal respiratory distress syndrome in premature neonates.
Method: This cross-sectional and applied study was performed on 91 infants with gestational age between 28-40 weeks for 6 months in 2013. In this study, lamellar body count test was performed for all infants. Lamellar body count was performed by a cell counter (Sysmex model K-X21). ROC Curve was also used for data analysis.
Results: Among 91 samples, 14 cases (15.4%) had respiratory distress syndrome. There were significant relationship between the prevalence of respiratory distress and gender (P=0.05), gestational age (P=0.01) and neonatal weight (P=0.01). The best cut off point for lamellar body count was less or more than 22500. Also, sensitivity, specificity, positive and negative predictive values were 94.7%, 100%, 100% and 94.7%, respectively.
Conclusion: Lamellar body count is a useful test for screening in terms of neonatal pulmonary surfactant. The test has appropriate sensitivity and specificity in the diagnosis of respiratory distress syndrome.

کلیدواژه‌ها [English]

  • Lamellar body
  • neonate
  • respiratory distress syndrome
  • Surfactant
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