肺超声评分预测新生儿呼吸窘迫综合征合并支气管肺发育不良的临床价值  

Clinicalvalueof pulmonary ultrasoundscorein predicting neonatalrespiratory distress syndrome with bronchopulmonary dysplasia

作　　者：卫晶丽[1] 李敏 李娜[1] 何欢 刘百灵[1] WEI Jingli;LI Min;LI Na;HE Huan;LIU Bailing(Department of Ultrasound,Xi’an Children’s Hospital,Xi’an 710003,China)

机构地区：[1]西安市儿童医院超声科,710003

出　　处：《临床超声医学杂志》2021年第1期45-48,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨肺超声评分预测新生儿发生呼吸窘迫综合征(NRDS)合并支气管肺发育不良(BPD)的临床价值。方法选取我院收治的158例NRDS患儿,均行肺部超声检查,计算肺超声评分,并收集患儿一般临床资料。依据是否合并BPD将其分为BPD组71例和非BPD组87例,比较两组患儿肺超声评分和临床资料的差异。绘制受试者工作特征(ROC)曲线分析肺超声评分预测NRDS合并BPD的诊断效能,探讨肺超声评分与不同治疗方式间的相关性。结果两组患儿在胎龄、出生体质量、住院时间、持续气道正压呼吸时间、机械通气时间、Apgar评分比较,差异均有统计学意义(均P<0.05);在性别、双胎数、常规氧疗时间、宫内感染及新生儿肺炎发生率方面比较,差异均无统计学意义。BPD组肺超声评分为(39.15±4.26)分,高于非BPD组(26.23±5.89)分,差异有统计学意义(P<0.001)。肺超声评分预测新生儿NRDS合并BPD的曲线下面积为0.832,以37分为截断值,其诊断敏感性78.0%,特异性89.0%,阳性预测值86.7%,阴性预测值74.5%。患儿肺超声评分与采用的呼吸治疗方式呈正相关(r=0.47,P<0.05)。结论肺超声评分有助于预测NRDS患儿是否合并BPD,为其进行合理的诊断治疗提供较可靠的影像依据。Objective To investigate the clinical value of pulmonary ultrasound score in predicting neonatal respiratory distress syndrome(NRDS)combined with bronchopulmonary dysplasia(BPD).Methods A total of 158 children with NRDS admitted to our hospital were selected for pulmonary ultrasound examination.Pulmonary ultrasound score was calculated,and general clinical data of the children were collected.The children were divided into BPD group(n=71)and non-BPD group(n=87)according to whether they were combined with BPD.The differences in pulmonary ultrasound scores and clinical data between the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of pulmonary ultrasound scores in predicting NRDS combined with BPD,and the correlation between pulmonary ultrasound scores and different treatment modality was analyzed.Results There were statistically significant differences between the two groups in gestational age,birth weight,time of hospitalization,continuous positive airway pressure breathing and mechanical ventilation time,and Apgar score(all P<0.05).There were no statistically significant differences in gender,number of twins,time of conventional oxygen therapy,intrauterine infection and incidence of neonatal pneumonia between the two groups.The pulmonary ultrasound score of the BPD group was 39.15±4.26,which was higher than that of the non-BPD group(26.23±5.89),and the difference was statistically significant(P<0.001).The area under the curve of pulmonary ultrasound score for predicting neonatal NRDS combined with BPD was 0.832.The diagnostic sensitivity,specificity,positive predictive value and negative predictive value were 78.0%,89.0%,86.7%and 74.5%with a cutoff value of 37.There was a positive correlation between pulmonary ultrasound scores and respiratory therapy(r=0.47,P<0.05).Conclusion Pulmonary ultrasound scoring method can help predict whether children with NRDS are associated with BPD,and can provide reliable imaging evidence for their reasonable dia

关 键 词：超声检查 肺 新生儿 呼吸窘迫综合征 支气管肺发育不良 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]