肺超声对小儿社区获得性肺炎的诊断可靠性分析  

Reliability analysis of PUS,CXR and CT in the diagnosis of children with community acquired pneumonia

作　　者：牛慧敏[1] 高洁[1] 于明月[1] 薛红元[1] 周冉 NIU Hui-min;GAO Jie;YU Ming-yue;XUE Hong-yuan;ZHOU Ran(Department of Ultrasound,Hebei General Hospital,Shijiazhuang,Hebei 050051,China)

机构地区：[1]河北省人民医院超声科,河北石家庄050051 [2]河北省人民医院儿科,河北石家庄050051

出　　处：《临床肺科杂志》2019年第7期1180-1184,共5页Journal of Clinical Pulmonary Medicine

基　　金：河北省卫计委重点课题计划(No 20170344)

摘　　要：目的探讨肺超声(LUS)和胸部X线检查(CXR)在小儿社区获得性肺炎(CAP)诊断中的准确性。方法将116例患者根据是否进行CT检测分为两组,比较两组间的差异,计算评分者信度(IRR),分析患儿的阴性和阳性预测值。结果IRR分析显示LUS诊断效果为中等(0.57),CXR较差(0.37)。在肺部正常检测中,LUS比CXR更敏感(79%vs41%),在特异性方面,除在“其他”类异常外,CXR高于LUS,具有统计学意义。除“其他”类型外,CXR的阳性预测值均较高。结论LUS在诊断CAP上具有较高的评判信度。与胸部CT相比,LUS和CXR敏感性相近,CXR在CAP的诊断具有更好的特异性。Objective To evaluate the reliability of lung ultrasonography(LUS)and chest radiography(CXR)in the diagnosis of children with community-acquired pneumonia(CAP).Methods 116 patients were divided into two groups according to whether or not to continue CT.The Kappa values were evaluated,and the negative and positive predictive values were determined according to the potential group model.Results IRR analysis showed that the diagnostic effect of LUS was 0.57,but the diagnostic effect of CXR was 0.37.In normal lung detection,LUS was more sensitive than CXR(79%vs 41%).Exclusion of"other"abnormalities,the specificity of CXR was higher than that of LUS,which was statistically significant.There was no statistical difference in negative predictive value between LUS and CXR except for“other”type.The positive predictive value of CXR was higher than that of LUS.Conclusion LUS has high reliability in diagnosing CAP.Compared with chest CT,the sensitivity of LUS and CXR is similar.The specificity of CXR in the diagnosis of CAP is better.

关 键 词：肺超声 胸部X线 社区获得性肺炎 小儿 

分 类 号：R725.6[医药卫生—儿科] R445.1[医药卫生—临床医学]