肺脏超声对32周以下早产儿支气管肺发育不良的诊断价值  

Diagnostic value of lung ultrasound for bronchopulmonary dysplasia in premature infants under 32 weeks

作　　者：宝凌云[1] 李明盼 李佳欣 高瑾[1] BAO Lingyun;LI Mingpan;LI Jiaxin;GAO Jin(Neonatology Department,Kunming Children's Hospital,Kunming 650021,China)

机构地区：[1]云南省昆明市儿童医院新生儿科,云南昆明650021

出　　处：《临床医学研究与实践》2025年第8期106-109,共4页Clinical Research and Practice

基　　金：昆明市卫生健康委员会卫生科研课题项目(No.2022-06-03-007)。

摘　　要：目的探讨肺脏超声对32周以下早产儿支气管肺发育不良(BPD)的诊断价值。方法选取2022年1月至2023年8月在昆明市儿童医院新生儿科住院的184例胎龄32周以下的早产儿为研究对象,根据患儿是否出现BPD,将其分为BPD组和非BPD组。分别在出生后3、7、14 d行肺脏超声检查,比较两组的超声影像特征及超声评分,绘制受试者工作特征(ROC)曲线评估肺脏超声对32周以下早产儿BPD的诊断价值。结果矫正胎龄36周时75例确诊为BPD(40.76%)。BPD组的有创机械通气时间、无创机械通气时间及用氧时间长于非BPD组(P<0.05)。BPD组融合B线或致密B线、肺间质综合征、胸膜线虫蚀样改变及胸膜线下囊泡样改变占比高于非BPD组(P<0.001)。出生后3、7、14 d,BPD组的肺脏超声评分高于非BPD组(P<0.001)。出生后3、7、14 d肺脏超声评分的曲线下面积(AUC)均>0.5,诊断性能良好。结论出生后14 d内的肺脏超声评分对32周以下早产儿BPD具有良好的诊断价值。Objective To explore the diagnostic value of lung ultrasound for bronchopulmonary dysplasia(BPD)in premature infants under 32 weeks.Methods A total of 184 premature infants with gestational age less than 32 weeks who were hospitalized in the neonatology department,Kunming Children's Hospital from January 2022 to August 2023 were selected as the research objects.According to whether the infants had BPD,the premature infants were divided into BPD group and non-BPD group.Lung ultrasound examination was performed at 3,7 and 14 d after birth.The ultrasound image features and ultrasound scores of the two groups were compared.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of lung ultrasound for BPD in premature infants under 32 weeks.Results BPD was diagnosed in 75 cases(40.76%)at 36 weeks of corrected gestational age.The invasive mechanical ventilation time,non-invasive mechanical ventilation time and oxygen use time in the BPD group were longer than those in the non-BPD group(P<0.05).The proportion of fusion B line or dense B line,pulmonary interstitial syndrome,pleural nematode erosion and subpleural vesicle changes in the BPD group were higher than those in the non-BPD group(P<0.001).At 3,7 and 14 d after birth,the lung ultrasound score of the BPD group was higher than that of the non-BPD group(P<0.001).The area under curve(AUC)of ultrasound score at 3,7 and 14 d after birth was>0.5,with good diagnostic performance.Conclusion The lung ultrasound score within 14 d after birth has a good diagnostic value for BPD in premature infants under 32 weeks.

关 键 词：肺脏超声 早产儿 超声评分 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]