不同肺超声阳性诊断标准评价心源性肺水肿的价值比较  

Comparison of Different Positive Diagnostic Criteria of Pulmonary Ultrasound in Evaluating Cardiogenic Pulmonary Edema

作　　者：胡晓露 HU Xiao-lu(Shanghai First People’s Hospital Bengbu Hospital)

机构地区：[1]上海市第一人民医院蚌埠医院

出　　处：《中国标准化》2024年第20期247-250,共4页China Standardization

摘　　要：目的:探究不同肺超声阳性诊断标准评价心源性肺水肿的价值。方法:选取在上海市第一人民医院蚌埠医院就诊的心衰患者40例,采用6点法(基于胸膜线和B线)进行肺超声检查。根据阳性点的个数及分布定义3种阳性标准:标准1为至少有2个阳性点;标准2为至少有3个阳性点;标准3为每侧至少有1个阳性点。比较3种肺超声阳性标准诊断心源性肺水肿的效能。结果:标准1、标准2、标准3在灵敏度上分别达到了88%、72%、79%,这意味着这些标准在检测心源性肺水肿时具有较高的敏感性。而在特异度方面,三者分别为89%、100%、93%。标准1、标准2、标准3均保持在87%左右。标准2在诊断心源性肺水肿时与临床最终诊断结果展现出了高度的一致性,Kappa值高达0.877。标准1和标准3的,Kappa值也分别达到了0.783和0.727。结论:3种肺超声阳性标准诊断心源性肺水肿的效能均较高,以“任意一侧,至少有3个阳性点”为标准,更有助于诊断。Objective:To explore the value of different positive diagnostic criteria of pulmonary ultrasound in evaluating cardiogenic pulmonary edema.Methods:A total of 40 patients with heart failure treated in Shanghai First People’s Hospital Bengbu Hospital were selected to perform lung ultrasound examination using 6-point method(based on pleural line and B-line).Three positive criteria were defi ned according to the number and distribution of positive points:Criterion 1 was at least 2 positive points;Criterion 2 is at least 3 positive points;Criterion 3 is at least one positive spot on each side.The efficacy of three positive pulmonary ultrasound criteria in the diagnosis of cardiogenic pulmonary edema was compared.Results:The sensitivity of Criterion 1,Criterion 2 and Criterion 3 reached 88%,72%and 79%respectively,which means that these criteria have high sensitivity in detecting cardiogenic pulmonary edema.In terms of specificity,they were 89%,100%and 93%,respectively.Criterion 1,Criterion 2,Criterion 3 are maintained at about 87%.Criterion 2 showed a high consistency between the diagnosis of cardiogenic pulmonary edema and the final clinical diagnosis,with a Kappa value of 0.877.The Kappa value of Criterion 1 and Criterion 3 also reached 0.783 and 0.727,respectively.Conclusion:The three positive pulmonary ultrasound criteria are more effective in the diagnosis of cardiogenic pulmonary edema,and“at least 3 positive points on either side”as the criterion is more helpful for diagnosis.

关 键 词：不同肺超声阳性诊断标准 心源性肺水肿 效能对比 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]