改良肺超声评分对支气管肺发育不良新生儿预后的预测效能  

Prognostic efficacy of modified lung ultrasound score in neonates with bronchopulmonary dysplasia

作　　者：唐文秀[1] 高月[1] 陈伟[1] 邹永蓉 梅林 TANG Wenxiu;GAO Yue;CHEN Wei;ZOU Yongrong;MEI Lin(Department of Neonatology,Ya’an People’s Hospital,Ya’an 625000,China)

机构地区：[1]雅安市人民医院新生儿科,四川雅安625000

出　　处：《中国中西医结合影像学杂志》2025年第1期88-92,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨改良肺超声评分(mLUS)对支气管肺发育不良(BPD)新生儿预后的预测效能。方法:纳入122例胎龄<34周的早产儿作为研究对象,根据有无BPD,分为无BPD组28例和BPD组94例;并根据BPD严重程度将BPD组分为轻度组30例、中度组33例及重度组31例。采用Pearson相关系数分析mLUS与患儿短期临床预后的相关性,ROC曲线分析mLUS对短期临床预后的预测效能。结果:无BPD组及BPD轻度组、中度组、重度组的孕龄、出生体质量、Apgar评分、出生后全身类固醇治疗、校正胎龄40周时呼吸支持情况及出院时的氧气需求比较,差异均有统计学意义(均P<0.05)。Pearson相关系数分析显示:mLUS与BPD严重程度、全身类固醇治疗、校正胎龄40周时呼吸支持情况及出院时的氧气需求均呈正相关(r=0.835,0.714,0.581,0.779;均P<0.05);LUS与BPD严重程度、全身类固醇治疗及校正胎龄40周时呼吸支持情况均呈正相关(r=0.766,0.637,0.571;均P<0.05),与出院时的氧气需求无相关性(r=0.601,P=0.153)。ROC曲线分析显示,mLUS预测BPD严重程度的AUC为0.944(95%CI0.877~0.981),LUS的AUC为0.852(95%CI0.764~0.917)。DeLong检验显示,mLUS与LUS的AUC差异有统计学意义(Z=2.222,P=0.026)。结论:mLUS与BPD严重程度及其他短期临床结果显著相关,且能较好地预测新生儿的预后。Objective:To analyze the predictive efficacy of modified lung ultrasound score(mLUS)on the prognosis of neo-nates with bronchopulmonary dysplasia(BPD).Methods:122 premature infants with less than 34 weeks gestational age were included as the study subjects.According to the occurrence of BPD,they were divided into non-BPD group(28 cases)and BPD group(94 cases),and the BPD group was further divided into a mild group(30 cases),a moderate group(33 cases)and a severe group(31 cases)according to the disease severity.Pearson correlation coefficient analysis was used to investigate the correlation between mLUS and short-term clinical prognosis,and ROC curve analysis was used to assess the predictive efficacy of mLUS in predicting short-term clinical prognosis.Results:There were significant differences in gestational age,birth weight,Apgar score,systemic steroid therapy after birth,respiratory support at 40 weeks of postmenstrual age and oxygen demand at discharge among the non-BPD group,mild group,moderate group and severe group(all P<0.05).Pearson correlation coefficient analysis results showed that the mLUS was positively correlated with the severity of BPD,systemic steroid therapy,respiratory support at 40 weeks of postmenstrual age and oxygen demand at discharge(r=0.835,0.714,0.581,0.779,all P<0.05),while LUS was positively correlated with BPD severity,systemic steroid therapy and respiratory support at 40 weeks of postmenstrual age(r=0.766,0.637,0.571,all P<0.05),and not correlated with oxygen demand at discharge(r=0.601,P=0.153).ROC curve analysis showed that the AUCs of mLUS and LUS in predicting the severity of BPD were 0.944(95%CI 0.877—0.981),0.852(95%CI 0.764—0.917),with a statistical difference(Z=2.222,P=0.026).Conclusions:The parameter of mLUS is significantly correlated with the severity of BPD and other short-term clinical outcomes,and can effectively predict these clinical outcomes in newborns.

关 键 词：改良肺超声评分 支气管肺发育不良 早产 预后 

分 类 号：R722.1[医药卫生—儿科] R445.1[医药卫生—临床医学]