肺部超声联合血浆SDC-1评估双肺移植术后患者血管外肺水状态  

To evaluate the extravascular lung water in patients of bilateral lung transplantation with lung ultrasonography and SDC-1

作　　者：高嵩[1] 吴丁烨[1] 陈耿靖[1] 金科[1] 张锋[1] 许红阳[1] Gao Song;Wu Dingye;Chen Genjing;Jin Ke;Zhang Feng;Xu Hongyang(Department of ICU,Wuxi Public Hospital,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡市人民医院重症医学科,214023

出　　处：《中华胸心血管外科杂志》2020年第2期94-97,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨应用肺部超声技术结合血浆多配体聚糖-1(SDC-1)对于双肺移植术后患者肺水肿严重程度的评估。方法选择2017年至2018年在南京医科大学附属无锡市人民医院行双肺移植手术患者50例,术中均放置Picco导管,术后入ICU 2 h后由1名医师监测Picco指标血管外肺水指数(EVLWI)和肺血管通透指数(PVPI)。同时由另1名医师进行床旁肺部超声检査,在肺部超声常规检测位点(上蓝点、下蓝点、膈肌点、Plaps点、后蓝点)进行检测,监测B线数目,然后计算总和。随后该医师采用ELISA法测定血清中SDC-1水平。结果双肺移植患者EVLWI同超声B线数目及血浆SDC-1水平均呈正相关(Pearson相关系数RS分别为0.833、0.747,P<0.05),PVPI同B线数目及血浆SDC-1水平同样均呈正相关(Pearson相关系数RS分别为0.738、0.626,P<0.05)。结论超声检测的B线数量及血浆SDC-1水平与双肺移植术后患者的血管外肺水状态有着良好的相关性,将两指标联合应用可作为评估双肺移植术后肺水肿程度的可靠依据。Objective The purpose of this study was to explore new method for evaluating the severity of extravascular lung water in patients after bilateral lung transplantation.Methods The study was performed in 50 patients after bilateral lung transplantation in our hospital from 2017 to 2018.Picco were implanted during the operation.Two hours after the operation,a doctor monitored the index of EVLWI and PVPI.At the same time,another doctor carried out examination of lung ultrasonography and Calculated the numbers of B line.After ultrasonography,the doctor used ELISA to determine the level of SDC-1.Results EVLWI were significantly correlated with the number of B-line and the level of SDC-1(RS=0.833,RS=0.747,P<0.05),PVPI were significantly correlated with the number of B-line and the level of SDC-1(RS=0.738,RS=0.626,P<0.05).Conclusion The number of B-line and the level of SDC-1 have a good correlation with extravascular lung water.The combination of the two indicators might be used as a reliable index for evaluating the degree of extravascular lung water after bilateral lung transplantation.

关 键 词：双肺移植 血管外肺水 肺部超声 血浆多配体聚糖-1 

分 类 号：R65[医药卫生—外科学]