燕亚茹,赵浩天,刘奕,龙玲,赵鹤龄,杨春燕.改良肺超声评分用于评估急性呼吸窘迫综合征严重程度[J].中国医学影像技术,2024,40(5):740~744
改良肺超声评分用于评估急性呼吸窘迫综合征严重程度
Modifying lung ultrasound score for evaluation on severity of acute respiratory distress syndrome
投稿时间:2023-11-24  修订日期:2024-01-06
DOI:10.13929/j.issn.1003-3289.2024.05.023
中文关键词:  呼吸窘迫综合征  超声检查  放射摄影术,胸部  氧合指数
英文关键词:respiratory distress syndrome  ultrasonography  radiography, thoracic  oxygenation index
基金项目:河北省医学科学研究课题计划项目(20211264、20211228)。
作者单位E-mail
燕亚茹 石家庄市人民医院超声科, 河北 石家庄 050051
河北医科大学研究生学院, 河北 石家庄 050017 
 
赵浩天 河北省人民医院超声科, 河北 石家庄 050051  
刘奕 河北省人民医院超声科, 河北 石家庄 050051  
龙玲 河北省人民医院重症医学科, 河北 石家庄 050051  
赵鹤龄 河北省人民医院重症医学科, 河北 石家庄 050051  
杨春燕 石家庄市人民医院超声科, 河北 石家庄 050051 chunyancsk@126.com 
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中文摘要:
      目的 提出改良肺超声评分(LUS),观察其用于评估急性呼吸窘迫综合征(ARDS)严重程度的价值。方法 回顾性分析33例突发ARDS患者肺超声及X线胸片等资料,根据氧合指数(OI)将患者归入中-重度组(n=16)及轻度组(n=17);比较组间LUS、改良LUS及肺水肿放射学(RALE)评分;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析影像学评分评估ARDS严重程度的效能;以Pearson相关分析观察ARDS患者影像学评分与OI的相关性,以及RALE评分与LUS及改良LUS的相关性。结果 中-重度组LUS及改良LUS均高于轻度组(P均<0.05);RALE评分组间差异无统计学意义(P>0.05)。以LUS、改良LUS及RALE评分评估ARDS严重程度的AUC分别为0.809、0.853及0.640。ARDS患者LUS及改良LUS均与OI呈中度负相关(r=-0.570,P=0.001;r=-0.708,P<0.001),而RALE评分与OI无明显相关(r=-0.229,P=0.201)。ARDS患者 RALE评分与LUS及改良LUS均呈中度正相关(r=0.588,P<0.001;r=0.502,P=0.003)。结论 本研究提出的改良LUS可有效评估ARDS严重程度,且其效能优于LUS及RALE评分。
英文摘要:
      Objective To propose a modified lung ultrasound score (LUS), and to observe its value for evaluation on severity of acute respiratory distress syndrome (ARDS). Methods Data of lung ultrasound, chest X-ray and so on in 33 sudden ARDS patients were retrospectively analyzed. The patients were divided into moderate-severe group (n=16) and mild group (n=17) according to oxygenation index (OI). The outcomes of LUS, modified LUS and radiographic assessment of lung edema (RALE) score were compared between groups. Receiver operating characteristic (ROC) curves were drawn, the area under the curves (AUC) were calculated to evaluate the efficacy of various image scores for evaluating the severity of ARDS. Pearson correlation analysis was performed to explore the correlations of various image scores with OI, of RALE score with LUS and modified LUS in ARDS patients. Results LUS and modified LUS in moderate-severe group were both higher than those in mild group (both P<0.05). No significant difference of RALE score was found between groups (P>0.05). AUC of LUS, modified LUS and RALE score for evaluating the severity of ARDS was 0.809, 0.853 and 0.640, respectively. LUS and modified LUS in ARDS patients were moderately negatively correlated with OI (r=-0.570, P=0.001; r=-0.708, P<0.001), while no obvious correlation of RALE score and OI was found (r=-0.229, P=0.201). RALE score of ARDS patients was moderately positively correlated with both LUS and modified LUS (r=0.588, P<0.001; r=0.502, P=0.003). Conclusion The above mentioned modified LUS could effectively evaluate severity of ARDS, with better efficacy than LUS and RALE score.
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