妊娠中后期小尾寒羊胎儿成熟监测
|
摘要
实验采用羊膜腔穿刺法及剖腹产法采集小尾寒羊妊娠中后期(80天～分娩)羊水，用分光光度计测定、试剂盒检测及一维薄层色谱的方法进行了羊水浊度、吸光度、总胆红素和肌酐含量及磷脂含量变化进行了研究；采用剖腹产方法取出妊娠中后期胎儿，分别用刻度尺测量及天平称重的方法对小尾寒羊胎儿的形态指标及内脏器官重量指标进行了测量；同时，对发育中后期小尾寒羊胎儿心、肺、肝、脾、肾和肾上腺皮质在发育过程中的组织结构变化及肺、垂体和肾上腺皮质的超微结构进行了研究。以揭示小尾寒羊胎儿，在妊娠中后期发育过程中的形态、内脏重量变化情况，器官发育过程中的显微、亚显微结构变化规律，从而为组织学与胚胎学提供参考以及填补动物胚胎学中的空白；以及揭示羊水指标与胎儿成熟度之间的关系，以利于兽医临床的应用。结果表明：
1 小尾寒羊胎儿羊水的吸光度、磷脂含量研究以及显微与超微结构的观察结果表明，羊水指标可反应胎羊肺成熟度。其成熟度的判断标准为：①650nm吸光度＞0.20；②羊水中卵磷脂与鞘磷脂比值(L/S)＞2；③羊水中磷脂酰甘油(PG)阳性。
2 小尾寒羊胎儿在胎龄为100天时出现被毛，并且仅存在于角突、下颌与颈部，120天时全身均有被毛。另外，胎儿皮肤在120天时生长较快。
3 光镜观察发现，小尾寒羊胎儿胎龄至80天时其心脏组织发育已经基本完善。
4 小尾寒羊胎儿肝脏的光镜观察结果表明，在胎儿期，肝脏为造血器官，并且在胎龄为100天时其造血功能最强，随后下降，分娩时其造血功能停止。胎儿肝脏组织结构在胎龄为100天时已经完善，在胎龄140天时其肝功能成熟。
5 小尾寒羊胎儿肺脏的光镜与透射电镜观察结果表明，胎儿胎龄到140天时，其肺脏组织结构成熟，此期肺泡结构完整，肺泡中Ⅱ型细胞中板层小体数量丰富，且与分娩时结构无明显差异，胎儿肺泡中Ⅱ型细胞在胎龄达100天时开始分化形成，胎龄达120天时出现成熟的肺泡Ⅱ型细胞。
6 小尾寒羊肾脏的光镜观察结果显示，在胎龄为80天时，肾脏已经有滤尿的功能，其结构与功能在胎龄到120天时完全成熟，此期胎肾中的肾小体已经全部为成熟的肾小体。小尾寒羊胎肾中肾小体的发育模式为，肾皮质由深到浅可呈现数代处于不同发育阶段的肾小体，在肾皮质深层肾小体先发育成熟，表层不断形成新的肾小体使皮质增厚。
7 光镜观察小尾寒羊胎儿脾脏的结果说明，在胎儿期脾脏为造血器官，造血功能在120天时开始下降，但在出生时仍具有造血功能。另外，脾脏在胎龄为80天时已经有白髓，但体积较小，随胎龄的增加白髓的体积增大。到120天时已经有明显的白髓，所以在胎龄为100～120天期间，可能为胎儿脾脏从造血器官向免疫器官转化的重要发育阶段。
8 小尾寒羊胎儿肾上腺皮质的光镜和透射电镜观察说明，胎儿期肾上腺皮质增厚主要是由于皮质中束状带增长的结果。皮质中束状带细胞合成活动随胎龄增加而加强，在分娩时合成能力旺盛。
9 小尾寒羊胎儿垂体的透射电镜观察显示，垂体前叶中分泌细胞的合成与分泌活动随胎龄的增长而加强。
The changes in amniotic fluid of absorbance, total bilirubin, creatinine and phospholipids contents were studied by using spectrophotometer, detecting kit, and one-dimensional thin-layer chromatography; the outer shape and inner organs' weight were measured by scales; the structure changes of several inner organs were studied by light microscope and transmission electron microscope. The objectives of the study were to discover the changes of the outer shape and the inner organs' weight, the changes rules of the microstructure and ultrastructure in these organs, and the relationship between amniotic fluid index and fetal maturity during the mid to late pregnancy period. The results showed that:
1. the amniotic absorbance and phospholipids level studies and ultrastructure observation results showed that the amniotic fluid index can be used to indicate fetal maturity. The standards for fetal maturity were: (1) absorbance at 650nm >0.20; (2) the lecithin and sphingomyelin ratio(L/S )>2;(3) the phosphatidylglycerol (PG) positive in amniotic fluid.
2 The hair of the sheep fetus were first observed in 100 days of the gestation by naked eyes only at the place of horn swelling, lower mandible and neck, by 120 days of gestation the fetus body was all covered by hair. In addition, the skin of the fetal sheep was growing faster at 120 days of gestation.
3 The light microscope observation results showed that the structure of the fetal heart was well developed by 80 days of gestation; the fetal liver was a hematopoietic organ. It's function reached the highest at 100 days of gestation, then declined The hematopoietic function of the fetal liver disappeared when the fetus was delivered. The structure of the fetal liver was well developed by 100 days of gestation, but it's function matured at 140 days of gestation; the kidneys already had the urine filtering function at 80 days of gestation. Their structure and function were well developed by 120 days of gestation. There were several kind of renal corpuscles in different periods coexisted in the cortex of the fetal kidneys, which was the development pattern of the renal corpuscles in fetal kidneys. The renal corpuscle in deeper cortex matured first There were new renal corpuscles forming constantly in the shallow cortex, which made the cortex thicken; the fetal spleen was a hematopoietic organ. It's hematopoietic function was declined at 120 days of gestation, but still existed after birth. In addition, the period from 100 days to 120 days of gestation was an important time for the fetal spleen to change from a hematopoietic organ to immune organ.
4 The results from light microscope and transmission electron microscope observation of the fetal lungs showed that the structure of the fetal lungs were well developed by 140 days of
gestation. The type II cells in alveolus began to differentiate at 100 days of gestation and appeared in maturity shape at 120 days of gestation; The thickening of the fetal sheep adrenal cortex was the result of increasing of the zona fasciculata. The synthetic activities of the cells in zona fasciculata increased with the fetal development, and the synthetic function was strong at delivery.
5 The transmission electron microscope observation results of fetal anterior pituitary showed that the synthetic and secretion activities increased with the fetal development
Graduate students: Xiujun Fan Speciality: Clinical Veterinary Medicine Supervisor: Professor Wenru Tian
1 小尾寒羊胎儿羊水的吸光度、磷脂含量研究以及显微与超微结构的观察结果表明，羊水指标可反应胎羊肺成熟度。其成熟度的判断标准为：①650nm吸光度＞0.20；②羊水中卵磷脂与鞘磷脂比值(L/S)＞2；③羊水中磷脂酰甘油(PG)阳性。
2 小尾寒羊胎儿在胎龄为100天时出现被毛，并且仅存在于角突、下颌与颈部，120天时全身均有被毛。另外，胎儿皮肤在120天时生长较快。
3 光镜观察发现，小尾寒羊胎儿胎龄至80天时其心脏组织发育已经基本完善。
4 小尾寒羊胎儿肝脏的光镜观察结果表明，在胎儿期，肝脏为造血器官，并且在胎龄为100天时其造血功能最强，随后下降，分娩时其造血功能停止。胎儿肝脏组织结构在胎龄为100天时已经完善，在胎龄140天时其肝功能成熟。
5 小尾寒羊胎儿肺脏的光镜与透射电镜观察结果表明，胎儿胎龄到140天时，其肺脏组织结构成熟，此期肺泡结构完整，肺泡中Ⅱ型细胞中板层小体数量丰富，且与分娩时结构无明显差异，胎儿肺泡中Ⅱ型细胞在胎龄达100天时开始分化形成，胎龄达120天时出现成熟的肺泡Ⅱ型细胞。
6 小尾寒羊肾脏的光镜观察结果显示，在胎龄为80天时，肾脏已经有滤尿的功能，其结构与功能在胎龄到120天时完全成熟，此期胎肾中的肾小体已经全部为成熟的肾小体。小尾寒羊胎肾中肾小体的发育模式为，肾皮质由深到浅可呈现数代处于不同发育阶段的肾小体，在肾皮质深层肾小体先发育成熟，表层不断形成新的肾小体使皮质增厚。
7 光镜观察小尾寒羊胎儿脾脏的结果说明，在胎儿期脾脏为造血器官，造血功能在120天时开始下降，但在出生时仍具有造血功能。另外，脾脏在胎龄为80天时已经有白髓，但体积较小，随胎龄的增加白髓的体积增大。到120天时已经有明显的白髓，所以在胎龄为100～120天期间，可能为胎儿脾脏从造血器官向免疫器官转化的重要发育阶段。
8 小尾寒羊胎儿肾上腺皮质的光镜和透射电镜观察说明，胎儿期肾上腺皮质增厚主要是由于皮质中束状带增长的结果。皮质中束状带细胞合成活动随胎龄增加而加强，在分娩时合成能力旺盛。
9 小尾寒羊胎儿垂体的透射电镜观察显示，垂体前叶中分泌细胞的合成与分泌活动随胎龄的增长而加强。
The changes in amniotic fluid of absorbance, total bilirubin, creatinine and phospholipids contents were studied by using spectrophotometer, detecting kit, and one-dimensional thin-layer chromatography; the outer shape and inner organs' weight were measured by scales; the structure changes of several inner organs were studied by light microscope and transmission electron microscope. The objectives of the study were to discover the changes of the outer shape and the inner organs' weight, the changes rules of the microstructure and ultrastructure in these organs, and the relationship between amniotic fluid index and fetal maturity during the mid to late pregnancy period. The results showed that:
1. the amniotic absorbance and phospholipids level studies and ultrastructure observation results showed that the amniotic fluid index can be used to indicate fetal maturity. The standards for fetal maturity were: (1) absorbance at 650nm >0.20; (2) the lecithin and sphingomyelin ratio(L/S )>2;(3) the phosphatidylglycerol (PG) positive in amniotic fluid.
2 The hair of the sheep fetus were first observed in 100 days of the gestation by naked eyes only at the place of horn swelling, lower mandible and neck, by 120 days of gestation the fetus body was all covered by hair. In addition, the skin of the fetal sheep was growing faster at 120 days of gestation.
3 The light microscope observation results showed that the structure of the fetal heart was well developed by 80 days of gestation; the fetal liver was a hematopoietic organ. It's function reached the highest at 100 days of gestation, then declined The hematopoietic function of the fetal liver disappeared when the fetus was delivered. The structure of the fetal liver was well developed by 100 days of gestation, but it's function matured at 140 days of gestation; the kidneys already had the urine filtering function at 80 days of gestation. Their structure and function were well developed by 120 days of gestation. There were several kind of renal corpuscles in different periods coexisted in the cortex of the fetal kidneys, which was the development pattern of the renal corpuscles in fetal kidneys. The renal corpuscle in deeper cortex matured first There were new renal corpuscles forming constantly in the shallow cortex, which made the cortex thicken; the fetal spleen was a hematopoietic organ. It's hematopoietic function was declined at 120 days of gestation, but still existed after birth. In addition, the period from 100 days to 120 days of gestation was an important time for the fetal spleen to change from a hematopoietic organ to immune organ.
4 The results from light microscope and transmission electron microscope observation of the fetal lungs showed that the structure of the fetal lungs were well developed by 140 days of
gestation. The type II cells in alveolus began to differentiate at 100 days of gestation and appeared in maturity shape at 120 days of gestation; The thickening of the fetal sheep adrenal cortex was the result of increasing of the zona fasciculata. The synthetic activities of the cells in zona fasciculata increased with the fetal development, and the synthetic function was strong at delivery.
5 The transmission electron microscope observation results of fetal anterior pituitary showed that the synthetic and secretion activities increased with the fetal development
Graduate students: Xiujun Fan Speciality: Clinical Veterinary Medicine Supervisor: Professor Wenru Tian
引文
1 曹贵方，荀崇文，蒙古绵羊早期胚胎心脏的组织发生，内蒙古农牧学院学报，1999，20(2)：30～34
2 党永辉，郑月茂，哺乳动物胎肺发育的形态学研究，动物医学进展，2001，22(4)：29～31
3 范同平，江月珍，羊水磷脂酰甘油等三项指标与胎儿肺成熟度分析，镇江医学院学报，1999，9(2)：256
4 范同平，张经，羊水稳定微泡试验测定胎儿肺成熟度，临床检验杂志，1999，17(5)：308
5 范秀军，孙郁柱，李生等，哺乳动物胎儿肺成熟检测方法的研究概况，动物医学进展，2002，23(5)：31～33
6 冯一奇，羊水磷脂酰甘油与泡沫试验联检在高危妊娠中的应用价值，苏州医学院学报，1999，19(7)：816～817
7 高羽，谭丽君，游泽山，羊膜腔内注射地塞米松促胎肺成熟剂量与安全性的研究，中华围产医学杂志，2000，3(2)：104～105
8 郭淑珠，宋鹤兰，李大庆等，单维薄层色谱法分析羊水碗脂在预测胎肺成熟中的应用，铁道医学，1999，27(2)：124
9 贺石林，李俊成，秦晓群等，临床生理学，科学出版社，2001：266～276
10 侯颖一，王文青，周晓彬等 胎儿肝脏发育的组织学及形态计量学和超微结构观察，青岛医学院学报，1999，35(2)：86～88
11 黄新民，张垒，胎儿垂体前叶激素释放的超微结构研究，解剖学报，1992，15(3)：175～176
12 姜俸蓉，许庭良，梁文妹等，人胎儿肾上腺的组织发生，解剖学报，1998，29(1)：102～105
13 金勤立，刘希红，肺泡表面活性物质中结合蛋白的作用，中国实用儿科杂志，1997，12(2)：69～71
14 金世宗，黄明华，方金荣等，13～41周胎儿11项生长发育指标的研究，1997，20(5)：504～508
15 李维芝，刘兴华，陈达常等，羊水滴法估计胎儿肺成熟度，中华妇产科杂志，1991，26(4)：228～230
16 李雪莲，张珏华，胎肺成熟度的判断，国外医学妇产科学分册，2000，27(1)：10～13
17 李振有、陈礼明、郑海洲主译，实验室数据的临床应用，天津简科技翻译出版公司出版，2000年第一版。
18 林乐明，张军，黄胜起等，应用一维薄层色谱法测暄羊水中磷脂化合物预测胎儿肺成熟度，色谱，1994，12(3)：171～172
19 刘斌，高英茂，人体胚胎学，1996年，第1版
20 刘鸿莲，王维国，苏承昌，胎儿肺成熟度羊水滴量仪的研制与应用，生物医学工程学杂志，1999，16(2)：209～212
21 刘凯，高英茂，马金龙等，人类胚胎脾组织发生的形态学观察，山东医科大学学报，1998，36(3)：197～200
22 刘凯，高英茂，马金龙等，人类胚胎肾组织发生的形态学观察，山东医科大学学报，1999，37(2)：100～102
23 刘凯，高英茂，马金龙等，在人类胚胎肝脏组织发生的形态学观察，山东医科大学学报，1997，35(2)：108～111
24 刘忠玉，吴淑兰，康文华等，对胎儿附睾超微结构的加龄研究，解剖学报，1996，19(4)：330～333
25 蒲力力，应用羊水荧光偏振度预测胎肺成熟度初探，实用妇科与产科杂志，1991，7(2)：95～96
26 戚庆炜，盖铭英，羊水在产前诊断中的作用，中国实用妇产科杂志，2000，16(8)：495～497
27 秦鹏春，李云龙，谭景和等哺孚恸物胚胎学，科学出版社，2001：383～389
28 施长春，费小阳，陈松涛，羊水表皮生长因子与胎肺成熟度的关系，上海第二医科大学学报，2000，20(6)：529～530
29 孙波，新生儿呼吸治疗技术的发展，中华儿科杂志，2000，38(10)：652～654
30 孙伟杰，杨慧霞，糖皮质激素促胎肺成熟，中国临床医生，2000，28(5)：18
31 王德智，乔宠，胎儿宫内治疗最新进展，中国实用妇科与产科杂志，1998，14(5)：260～262
32 王凤龙，靳全恒，段金云，羊水磷脂酰甘油测定预测胎肺成熟度，实用儿科临床杂志，1996，11(5)：276～277
33 魏克伦，李娟，糖皮质激素在新生儿临床应用中需注意的问题，中国实用儿科杂志，2000，15(1)：12～13
34 谢尔凡，杨宗城，肺表面活性物质相关蛋白表达的调控研究进展，中国药理学通报，1997，13(1)：18～21
35 徐永萍，刘培淑，戴曼笙，糖皮质激素与胎儿肺成熟的研究进展，中华妇产科杂志，2001，36(5)：311～313
36 袁健文，羊水三项指标预测妊娠合并胎肺成熟的价值，广东医学院学报，1996，14(4)：356～357
37 张金萍，张雷家，崔运河等，胎儿脏器重量评价胎儿发育状况的分析，济宁医学院学报，1998，21(4)：26～27
38 张晓红，吴铁占，朱凤全等，羊水淀汾同工酶分离测定在判断胎儿成熟度中的意义，白求恩医科大学学报，1998，24(2)：154～156
39 张炎虹，郭邑，毛爱华等，快速预测胎肺成熟的新方法，医师进修杂志，2000，23(5)：43
40 张炎虹，吴白涛，汤洁心等，应用羊水中板层小体计数预测胎肺成熟度，中华妇产
科杂志，1999，34(3)：176
41 章红志，杨毅，邢泉生等，用免疫印迹法测定肺表面活性蛋白A及其临床应用，上海医学检验杂志，1997，12(4)：211～212
42 赵三纯，邢丽霄，羊水生化检测的临床意义，中国实用妇科与产科杂志，2000，16(8)：459～461
43 钟慈声，程关荣，陈细法等，细胞和组织的超微结构，人民卫生出版社，1984：138～150；161～169
44 周晓光，罗先琼，肺表面活性物质对早产儿呼吸窘迫综合征的预防作用，中华围产医学杂志，1999，2(4)：253～254
45 严仁英主编，围产医学基础，1989：105～113
46 Alcorn DG, Adamson TM, Maloney JE et al., A morphologic and morphometric analysis of fetal lung development in the sheep. Anat Rec, 1981 Dec;201(4): 655～67
47 Boshier DP, Gavin CB, Holloway H., Morphometric analyses of adrenal gland growth in fetal and neonatal sheep. Ⅱ. The adrenal medulla, with some observations on its ultrastructure., J Anat, 1989 Dec;167:15～30
48 Brook WH, Connell S, Cannata J et al, Ultrastructure of the myocardium during development from early fetal life to adult life in sheep. J Anat 1983 Dec;137(Pt 4): 729～41
49 Bryden M M, Evans H, Binns W, et al. Embryology of the sheep Ⅲ: The respiratory system mesenteries and celom in the fourteen to thirty-four day embryo., J. Anat Rec, 1973, 175: 725～736.
50 Chapman J.E, Amniotic fluid test for fetal lung maturation-The good, the bad, and the promising, Clin. Lab. Sci., 1994,7(2): 95～99
51 Daine G, Alcorn T. Michael Adamson, et al. Amorphologic and morphometric analysis of fetal lung development in the sheep J. Anat Rec, 1981, 201: 655～667.
52 Divers W.A., Barbaknia A., Hopper B.R., et al., Fetal lung maturation: amniotic fluid catecholamines, phospholipids, and cortisol, Am. J. Obstet Gynecol., 1982,142(4): 440～444
53 Fierer JA., Ultrastructural studies of developing pulmonary alveolar sepial elastin., Adv Exp Med Biol, 1977;79:31～7
54 Fukuda Y, Ferrans VJ, Crystal RG., Development of elastic fibers of nuchal ligament, aorta, and lung of fetal and postnatal sheep: an ultrastructural and electron microscopic immunohistochemical study., Am J Anat, 1984 Aug;170(4): 597～629
55 Fukuda Y, Ferrans VJ, Crystal RG.,The development of alveolar septa in fetal sheep lung. An ultrastructural and immunohistochemical study., Am J Anat, 1983 Aug;167(4): 405～39
56 Gluck L. Kulovich M.V. Borer R.C. et al. Diognosis of the respiratory distress syndrome by emniocentesis. Am J Obstet Gynacol 1971;109:440～445
57 Jay L., Metabolic profiling of amniotic fluid by proton nuclear magnetic resonance
spectroscopy: Correlation with fetal maturation and other clinical variables, Clinical Chemistry, 1994,40(1): 56～61
58 Jeanne M.S., Susan A.M., An ultrastructural, morphometric analysis of rabbit fetal lung type Ⅱ cell differentiation in vivo, Anat. Rec., 1991, 229:73～85
59 Josefina R., Carmen Z., Alberto de la V., et al., Responsiveness of L-S ratio of the amniotic fluid to intra-amniotic administration of thyroxine, Acta Obstet Gynecol Scand, 1990, 69: 119～122
60 Karen E. W., Alan H. J., Machiko I., et al., Antenatal endotoxin arid glucocorticoid effects on lung morphometry in preterm lambs, Pediatric Research, 2000,48(6): 782～788
61 Laatikainen T.J. Raisanen I.J., Salminen K.R., Corticotrophin-releasing hormone in amniotic fluid during gestation and labor and in relation to fetal lung maturation, Am. J. Obstet. Gynecol., 1988, 159(4): 891～895
62 Lakritz J, Weir AJ, Mariassy AT et al., Ultrastructural morphometric characterization of alveolar type Ⅱ cells of perinatal sheep: a comparison with adults., Anat Embryol (Berl),1992 Sep;186(4): 355～362
63 Lin Y,, Lechner A.J., Ultrastructural analysis of regional type Ⅱ cell development within fetal and neonatal lungs, Am J Physiol. 1990 Dec; 259(6 Pt 1):L359～64
64 Lui KI等，通过羊水红外线光谱快速确定胎儿肺成熟度，实用妇产科杂志新医学文摘卡片，1998年第5期
65 Moore R.J., Strachan B., Tyler D.J., et al., In vivo diffusion measurements as an indication of fetal lung maturation using echo planar imaging at 0.5T, Magnetic Resonance in Medicine, 2001,45: 247～253
66 Rohlfs E.M., Chaing S.H., Chapmam J.E, Analytical and clinical evaluation of refractive inde-matched anomalous diffraction (RIMAD) for assessment of fetal lung maturation, Clin. Chem., 1996,42(11): 1861～1868
67 Sergel P. S., Richard EH., Margaret M.G., Development of Marcophages in the lungs of fetal rabbits, rats, and hamsters, The Anatomic Record, 1984,208: 103～121
68 Smolich JJ., Ultrastructural and functional features of the developing mammalian heart: a brief overview. Reprod Fertil Dev, 1995; 7(3): 451～61
69 Thomas L.G., Margaret V.W., Paul M.K., et al., Clinical laboratory determination of phospbatidylglycerol: one- and two-dimensional chromatography compared, Clinical Chemistry, 1981,27(3): 486～490
70 Michael. Y., Josephson M.W., Knox G.E., et al., Absorbance of amniotic fluid at 650 nm as a fetal lung maturity test: A comparison with the lecithin/sphingomyelin ratio and tests for disaturated phosphatidylcholine and phosphatidyiglycerol, Am. J. Obstet Gynecol., 1983,146(8): 963～966
71 Vandenberg G.A., Kingma A.W., Visser G.H., et al., Gestational-age-dependent concentrations of polyamines, their conjugates and metabolites in urine and amniolic fluid,
British J. Obstet Gynae., 1988,95:669～675
72 Vasquez F.A., Gomez M.A., Serrano J., et al., Structural and ultrastructural studies of GH, PRL and SMT ceils in goat fetus (capra hircus) using immunocytochemical methods, Arch. Histol. Cytol., 63(4): 319～326
73 Vernier, AL, Anderson, AB. Study of the human fetal kidney. Ⅰ. Development of the glomerulus. J Pediatrics, 1962, 60 (5): 754
74 Webb P.B., Development of the adrenal cortex in the fetal sheep: an ultrastructural study, J. of Development Physiology, 1980, 2:161～181
75 Webb P.B., Steven D.H., Development of the adrenal cortex in the fetal foal: an ultrastructural study, J. of Development Physiology 1981, 3:59～73
76 Webb P.B., The pars distalis (anterior pituitary) in the fetal sheep: an ultrastructural study, J. of Development Physiology, 1981, 3: 319～332
77 Webb P.B., The pars intermedia (intermediate lobe of the pituitary) in the fetal sheep: an ultrastrucural study, J. of Development Physiology, 1981, 3:309～318
78 Fukuda Y., Victor J.F., Ronald G.C., Development of elastic fibers of nuchal ligament, aorta and lung of fetal and postnatal sheep: An ultrastructural and electron microscopic immunohistochemical study, The American J. of Ana., 1984, 170:597～629
79 Fukuda Y, Victor J.E, Ronald G.C., The development of alveolar septa in fetal sheep lung: An ultrastructural and immunohistochemical study, The American J. of Ana., 1983, 167: 405～439
80 Zapata A., Hemandez-Garcia J.M., Fuente D.L., Amniotic fluid phospholipids and foetal lung maturation, Scand J Clin lab Invest, 1988, 48:39～43
2 党永辉，郑月茂，哺乳动物胎肺发育的形态学研究，动物医学进展，2001，22(4)：29～31
3 范同平，江月珍，羊水磷脂酰甘油等三项指标与胎儿肺成熟度分析，镇江医学院学报，1999，9(2)：256
4 范同平，张经，羊水稳定微泡试验测定胎儿肺成熟度，临床检验杂志，1999，17(5)：308
5 范秀军，孙郁柱，李生等，哺乳动物胎儿肺成熟检测方法的研究概况，动物医学进展，2002，23(5)：31～33
6 冯一奇，羊水磷脂酰甘油与泡沫试验联检在高危妊娠中的应用价值，苏州医学院学报，1999，19(7)：816～817
7 高羽，谭丽君，游泽山，羊膜腔内注射地塞米松促胎肺成熟剂量与安全性的研究，中华围产医学杂志，2000，3(2)：104～105
8 郭淑珠，宋鹤兰，李大庆等，单维薄层色谱法分析羊水碗脂在预测胎肺成熟中的应用，铁道医学，1999，27(2)：124
9 贺石林，李俊成，秦晓群等，临床生理学，科学出版社，2001：266～276
10 侯颖一，王文青，周晓彬等 胎儿肝脏发育的组织学及形态计量学和超微结构观察，青岛医学院学报，1999，35(2)：86～88
11 黄新民，张垒，胎儿垂体前叶激素释放的超微结构研究，解剖学报，1992，15(3)：175～176
12 姜俸蓉，许庭良，梁文妹等，人胎儿肾上腺的组织发生，解剖学报，1998，29(1)：102～105
13 金勤立，刘希红，肺泡表面活性物质中结合蛋白的作用，中国实用儿科杂志，1997，12(2)：69～71
14 金世宗，黄明华，方金荣等，13～41周胎儿11项生长发育指标的研究，1997，20(5)：504～508
15 李维芝，刘兴华，陈达常等，羊水滴法估计胎儿肺成熟度，中华妇产科杂志，1991，26(4)：228～230
16 李雪莲，张珏华，胎肺成熟度的判断，国外医学妇产科学分册，2000，27(1)：10～13
17 李振有、陈礼明、郑海洲主译，实验室数据的临床应用，天津简科技翻译出版公司出版，2000年第一版。
18 林乐明，张军，黄胜起等，应用一维薄层色谱法测暄羊水中磷脂化合物预测胎儿肺成熟度，色谱，1994，12(3)：171～172
19 刘斌，高英茂，人体胚胎学，1996年，第1版
20 刘鸿莲，王维国，苏承昌，胎儿肺成熟度羊水滴量仪的研制与应用，生物医学工程学杂志，1999，16(2)：209～212
21 刘凯，高英茂，马金龙等，人类胚胎脾组织发生的形态学观察，山东医科大学学报，1998，36(3)：197～200
22 刘凯，高英茂，马金龙等，人类胚胎肾组织发生的形态学观察，山东医科大学学报，1999，37(2)：100～102
23 刘凯，高英茂，马金龙等，在人类胚胎肝脏组织发生的形态学观察，山东医科大学学报，1997，35(2)：108～111
24 刘忠玉，吴淑兰，康文华等，对胎儿附睾超微结构的加龄研究，解剖学报，1996，19(4)：330～333
25 蒲力力，应用羊水荧光偏振度预测胎肺成熟度初探，实用妇科与产科杂志，1991，7(2)：95～96
26 戚庆炜，盖铭英，羊水在产前诊断中的作用，中国实用妇产科杂志，2000，16(8)：495～497
27 秦鹏春，李云龙，谭景和等哺孚恸物胚胎学，科学出版社，2001：383～389
28 施长春，费小阳，陈松涛，羊水表皮生长因子与胎肺成熟度的关系，上海第二医科大学学报，2000，20(6)：529～530
29 孙波，新生儿呼吸治疗技术的发展，中华儿科杂志，2000，38(10)：652～654
30 孙伟杰，杨慧霞，糖皮质激素促胎肺成熟，中国临床医生，2000，28(5)：18
31 王德智，乔宠，胎儿宫内治疗最新进展，中国实用妇科与产科杂志，1998，14(5)：260～262
32 王凤龙，靳全恒，段金云，羊水磷脂酰甘油测定预测胎肺成熟度，实用儿科临床杂志，1996，11(5)：276～277
33 魏克伦，李娟，糖皮质激素在新生儿临床应用中需注意的问题，中国实用儿科杂志，2000，15(1)：12～13
34 谢尔凡，杨宗城，肺表面活性物质相关蛋白表达的调控研究进展，中国药理学通报，1997，13(1)：18～21
35 徐永萍，刘培淑，戴曼笙，糖皮质激素与胎儿肺成熟的研究进展，中华妇产科杂志，2001，36(5)：311～313
36 袁健文，羊水三项指标预测妊娠合并胎肺成熟的价值，广东医学院学报，1996，14(4)：356～357
37 张金萍，张雷家，崔运河等，胎儿脏器重量评价胎儿发育状况的分析，济宁医学院学报，1998，21(4)：26～27
38 张晓红，吴铁占，朱凤全等，羊水淀汾同工酶分离测定在判断胎儿成熟度中的意义，白求恩医科大学学报，1998，24(2)：154～156
39 张炎虹，郭邑，毛爱华等，快速预测胎肺成熟的新方法，医师进修杂志，2000，23(5)：43
40 张炎虹，吴白涛，汤洁心等，应用羊水中板层小体计数预测胎肺成熟度，中华妇产
科杂志，1999，34(3)：176
41 章红志，杨毅，邢泉生等，用免疫印迹法测定肺表面活性蛋白A及其临床应用，上海医学检验杂志，1997，12(4)：211～212
42 赵三纯，邢丽霄，羊水生化检测的临床意义，中国实用妇科与产科杂志，2000，16(8)：459～461
43 钟慈声，程关荣，陈细法等，细胞和组织的超微结构，人民卫生出版社，1984：138～150；161～169
44 周晓光，罗先琼，肺表面活性物质对早产儿呼吸窘迫综合征的预防作用，中华围产医学杂志，1999，2(4)：253～254
45 严仁英主编，围产医学基础，1989：105～113
46 Alcorn DG, Adamson TM, Maloney JE et al., A morphologic and morphometric analysis of fetal lung development in the sheep. Anat Rec, 1981 Dec;201(4): 655～67
47 Boshier DP, Gavin CB, Holloway H., Morphometric analyses of adrenal gland growth in fetal and neonatal sheep. Ⅱ. The adrenal medulla, with some observations on its ultrastructure., J Anat, 1989 Dec;167:15～30
48 Brook WH, Connell S, Cannata J et al, Ultrastructure of the myocardium during development from early fetal life to adult life in sheep. J Anat 1983 Dec;137(Pt 4): 729～41
49 Bryden M M, Evans H, Binns W, et al. Embryology of the sheep Ⅲ: The respiratory system mesenteries and celom in the fourteen to thirty-four day embryo., J. Anat Rec, 1973, 175: 725～736.
50 Chapman J.E, Amniotic fluid test for fetal lung maturation-The good, the bad, and the promising, Clin. Lab. Sci., 1994,7(2): 95～99
51 Daine G, Alcorn T. Michael Adamson, et al. Amorphologic and morphometric analysis of fetal lung development in the sheep J. Anat Rec, 1981, 201: 655～667.
52 Divers W.A., Barbaknia A., Hopper B.R., et al., Fetal lung maturation: amniotic fluid catecholamines, phospholipids, and cortisol, Am. J. Obstet Gynecol., 1982,142(4): 440～444
53 Fierer JA., Ultrastructural studies of developing pulmonary alveolar sepial elastin., Adv Exp Med Biol, 1977;79:31～7
54 Fukuda Y, Ferrans VJ, Crystal RG., Development of elastic fibers of nuchal ligament, aorta, and lung of fetal and postnatal sheep: an ultrastructural and electron microscopic immunohistochemical study., Am J Anat, 1984 Aug;170(4): 597～629
55 Fukuda Y, Ferrans VJ, Crystal RG.,The development of alveolar septa in fetal sheep lung. An ultrastructural and immunohistochemical study., Am J Anat, 1983 Aug;167(4): 405～39
56 Gluck L. Kulovich M.V. Borer R.C. et al. Diognosis of the respiratory distress syndrome by emniocentesis. Am J Obstet Gynacol 1971;109:440～445
57 Jay L., Metabolic profiling of amniotic fluid by proton nuclear magnetic resonance
spectroscopy: Correlation with fetal maturation and other clinical variables, Clinical Chemistry, 1994,40(1): 56～61
58 Jeanne M.S., Susan A.M., An ultrastructural, morphometric analysis of rabbit fetal lung type Ⅱ cell differentiation in vivo, Anat. Rec., 1991, 229:73～85
59 Josefina R., Carmen Z., Alberto de la V., et al., Responsiveness of L-S ratio of the amniotic fluid to intra-amniotic administration of thyroxine, Acta Obstet Gynecol Scand, 1990, 69: 119～122
60 Karen E. W., Alan H. J., Machiko I., et al., Antenatal endotoxin arid glucocorticoid effects on lung morphometry in preterm lambs, Pediatric Research, 2000,48(6): 782～788
61 Laatikainen T.J. Raisanen I.J., Salminen K.R., Corticotrophin-releasing hormone in amniotic fluid during gestation and labor and in relation to fetal lung maturation, Am. J. Obstet. Gynecol., 1988, 159(4): 891～895
62 Lakritz J, Weir AJ, Mariassy AT et al., Ultrastructural morphometric characterization of alveolar type Ⅱ cells of perinatal sheep: a comparison with adults., Anat Embryol (Berl),1992 Sep;186(4): 355～362
63 Lin Y,, Lechner A.J., Ultrastructural analysis of regional type Ⅱ cell development within fetal and neonatal lungs, Am J Physiol. 1990 Dec; 259(6 Pt 1):L359～64
64 Lui KI等，通过羊水红外线光谱快速确定胎儿肺成熟度，实用妇产科杂志新医学文摘卡片，1998年第5期
65 Moore R.J., Strachan B., Tyler D.J., et al., In vivo diffusion measurements as an indication of fetal lung maturation using echo planar imaging at 0.5T, Magnetic Resonance in Medicine, 2001,45: 247～253
66 Rohlfs E.M., Chaing S.H., Chapmam J.E, Analytical and clinical evaluation of refractive inde-matched anomalous diffraction (RIMAD) for assessment of fetal lung maturation, Clin. Chem., 1996,42(11): 1861～1868
67 Sergel P. S., Richard EH., Margaret M.G., Development of Marcophages in the lungs of fetal rabbits, rats, and hamsters, The Anatomic Record, 1984,208: 103～121
68 Smolich JJ., Ultrastructural and functional features of the developing mammalian heart: a brief overview. Reprod Fertil Dev, 1995; 7(3): 451～61
69 Thomas L.G., Margaret V.W., Paul M.K., et al., Clinical laboratory determination of phospbatidylglycerol: one- and two-dimensional chromatography compared, Clinical Chemistry, 1981,27(3): 486～490
70 Michael. Y., Josephson M.W., Knox G.E., et al., Absorbance of amniotic fluid at 650 nm as a fetal lung maturity test: A comparison with the lecithin/sphingomyelin ratio and tests for disaturated phosphatidylcholine and phosphatidyiglycerol, Am. J. Obstet Gynecol., 1983,146(8): 963～966
71 Vandenberg G.A., Kingma A.W., Visser G.H., et al., Gestational-age-dependent concentrations of polyamines, their conjugates and metabolites in urine and amniolic fluid,
British J. Obstet Gynae., 1988,95:669～675
72 Vasquez F.A., Gomez M.A., Serrano J., et al., Structural and ultrastructural studies of GH, PRL and SMT ceils in goat fetus (capra hircus) using immunocytochemical methods, Arch. Histol. Cytol., 63(4): 319～326
73 Vernier, AL, Anderson, AB. Study of the human fetal kidney. Ⅰ. Development of the glomerulus. J Pediatrics, 1962, 60 (5): 754
74 Webb P.B., Development of the adrenal cortex in the fetal sheep: an ultrastructural study, J. of Development Physiology, 1980, 2:161～181
75 Webb P.B., Steven D.H., Development of the adrenal cortex in the fetal foal: an ultrastructural study, J. of Development Physiology 1981, 3:59～73
76 Webb P.B., The pars distalis (anterior pituitary) in the fetal sheep: an ultrastructural study, J. of Development Physiology, 1981, 3: 319～332
77 Webb P.B., The pars intermedia (intermediate lobe of the pituitary) in the fetal sheep: an ultrastrucural study, J. of Development Physiology, 1981, 3:309～318
78 Fukuda Y., Victor J.F., Ronald G.C., Development of elastic fibers of nuchal ligament, aorta and lung of fetal and postnatal sheep: An ultrastructural and electron microscopic immunohistochemical study, The American J. of Ana., 1984, 170:597～629
79 Fukuda Y, Victor J.E, Ronald G.C., The development of alveolar septa in fetal sheep lung: An ultrastructural and immunohistochemical study, The American J. of Ana., 1983, 167: 405～439
80 Zapata A., Hemandez-Garcia J.M., Fuente D.L., Amniotic fluid phospholipids and foetal lung maturation, Scand J Clin lab Invest, 1988, 48:39～43