肺超声B线积分对肺源性及肺外源性急性呼吸窘迫综合征血管外肺水的诊断研究  

Diagnostic value of lung ultrasound B-line score for direct acute respiratory distress syndrome and indirect acute respiratory distress syndrome

作　　者：王梅[1] 于亮[2] 韩卫华[2] WANG Mei;YU Liang;HAN Wei-hua(Dept.of Ultrasonography,Taian Central Hospital,Taian 271000,China;Respiratory Intensive Care Unit,Taian Central Hospital,Taian 271000,China)

机构地区：[1]泰安市中心医院特检科,山东泰安271000 [2]泰安市中心医院呼吸重症科,山东泰安271000

出　　处：《泰山医学院学报》2020年第1期22-25,共4页Journal of Taishan Medical College

摘　　要：目的探讨肺源性急性呼吸窘迫综合征(ARDSp)及肺外源性急性呼吸窘迫综合征(ARDSexp)患者血管外肺水的差异,评估肺超声B线积分对ARDS血管外肺水的诊断价值。方法分析17例ARDSp患者及24例ARDSexp患者的临床资料,确诊第3天,监测两组患者血管外肺水指数(extravascular lungwater index,ELWI)和肺超声B线积分,并进行相关性分析。确诊第10天,监测两组病情未缓解患者ELWI和肺超声B线积分并进行相关性分析。结果确诊第3天,两组ELWI和肺超声B线积分差异均有统计学意义(P<0.01),ARDSp组ELWI和肺超声B线积分高于ARDSexp组。确诊第10天,两组病情未缓解患者ELWI和肺超声B线积分差异无统计学意义(P>0.05)。确诊3天,两组ELWI和肺超声B线积分均呈正相关(r=0.655,r=0.504)。确诊10天,两组病情未缓解患者ELWI和肺超声B线积分也呈正相关(r=0.942,r=0.746)。结论两种不同类型ARDS早期肺水程度不同,肺超声B线积分对肺源性ARDS及非肺源性ARDS血管外肺水均有重要的诊断价值。Objective:To investigate the difference in extravascular lung water(EVLW)between direct acute respiratory distress syndrome(ARDSp)and indirect acute respiratory distress syndrome(ARDSexp),and to evaluate diagnostic value of lung ultrasound B-line score for pulmonary edema of ARDS.Methods:Seventeen patients with ARDSp and 24 patients with ARDS exp were analyzed.3d after confirmed diagnosis,the extravascular lungwater index(ELWI)and B-line score were monitored in two groups.Relationships between B line and extravascular lung water index(ELWI)were analyzed respectively.10d after confirmed diagnosis ELWI and B-line score were monitored in disremisson case of two groups.Relationships between B line and extravascular lung water index(ELWI)were analyzed respectively.Results:Difference on B line and ELWI in two groups had statistical significance(P<0.05),and B line was positively related to ELWI(r=0.655,r=0.504)in 3d after confirmed diagnosis.There were no difference on B line and ELWI in disremisson case of two groups in 10d after admission,but B line was still positively related to ELWI(r=0.942,r=0.746).Conclusion:Different levels of ELWI in two types of ARDS may suggest the different degree of pulmonary edema in early stage,lung ultrasound B-line score has important diagnostic value for extravascular lung water in ARDSp and ARDSexp.

关 键 词：肺源性急性呼吸窘迫综合征 肺外源性急性呼吸窘迫综合征 血管外肺水指数 肺超声B线积分 

分 类 号：R445.1[医药卫生—影像医学与核医学]