肺超声在1~3月龄婴儿社区获得性肺炎病情评估中的价值

doi:10.3969/j.issn.1004-583X.2024.03.006

摘要/Abstract

摘要：

目的探讨肺部超声评分(lung ultrasound score,LUSS)在1~3月龄婴儿社区获得性肺炎(community acquired pneumonia, CAP)病情评估的临床应用价值。方法收集1~3月龄且在入院48小时内完成肺超声检查的CAP患儿的临床资料,对病情程度进行定量评分及分级,分析病情程度与LUSS的相关性,应用ROC曲线评价LUSS对重症肺炎的评估价值。结果重症肺炎组LUSS[12.0(6.0, 21.5)]分高于轻症肺炎组[3.0(1.0, 8.0)]分(P<0.05), 病情严重程度与LUSS呈显著正相关(r=0.487,P<0.01),ROC曲线判断重症肺炎最佳界限为5.5分,敏感度和特异度分别为81.8%、69.6%。结论 LUSS可反映小于3月龄CAP患儿的病情严重程度,是临床评估病情的实用工具,可作为病情随访监测的工具。

关键词: 肺炎, 超声检查, 婴儿

Abstract:

Objective To evaluate the clinical value of lung ultrasound score (LUSS) in infants aged 1-3 months who suffered from community-acquired pneumonia (CAP). Methods Clinical data of infants with CAP at the age of 1-3 months and examined by lung ultrasound (LUS) within 48 hours after admission were collected. The severity of pneumonia was quantified and classified, and the correlation of disease severity with LUSS was analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the potential of the LUSS in predicting severe pneumonia. Results The LUSS was significantly higher in infants of severe pneumonia group than those of the mild pneumonia group (12.0[6.0, 21.5] points vs 3.0[1.0, 8.0] points, P<0.05). Disease severity was positively correlated with LUSS (r=0.487, P<0.01). The optimal cut-off value of LUSS in predicting severe pneumonia was 5.5 points, with the sensitivity and specificity of 81.8% and 69.6%, respectively. Conclusion LUSS reflects the severity of CAP in infants aged 1-3 months, and it is a practical tool for clinical evaluation and follow-up monitoring.

Key words: pneumonia, ultrasonography, infant

中图分类号:

R563.1

张霞, 唐艳, 刘文丽, 刘娟. 肺超声在1~3月龄婴儿社区获得性肺炎病情评估中的价值[J]. 临床荟萃, 2024, 39(3): 234-238.

Zhang Xia, Tang Yan, Liu Wenli, Liu Juan. Value of lung ultrasound in the assessment of community-acquired pneumonia in infants aged 1-3 months[J]. Clinical Focus, 2024, 39(3): 234-238.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.03.006

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I3/234

图/表 5

参考文献 26

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项目	0分	1分	2分	4分
呼吸频率(次/min)	29~61	≥61或≤29	≥81或≤19	≥91或≤15
吸气性凹陷	不使用辅助呼吸肌	轻微胸壁塌陷	中度胸壁塌陷	严重胸壁塌陷和呻吟
氧饱和度	>94%	91~94%	≤90%	-
氧疗情况	无	-	氧流量<4 L/min或FiO₂<50%	氧流量≥4 L/min或FiO₂>50%

项目	0分	1分	2分	4分
呼吸频率(次/min)	29~61	≥61或≤29	≥81或≤19	≥91或≤15
吸气性凹陷	不使用辅助呼吸肌	轻微胸壁塌陷	中度胸壁塌陷	严重胸壁塌陷和呻吟
氧饱和度	>94%	91~94%	≤90%	-
氧疗情况	无	-	氧流量<4 L/min或FiO₂<50%	氧流量≥4 L/min或FiO₂>50%

组别	例数	性别[例(%)]		体重(kg)	日龄(日)	湿啰音[例(%)]
组别	例数	男	女	体重(kg)	日龄(日)	有	无
轻症肺炎组	102	54(52.9)	48(47.1)	4.654±0.707	44.200±11.100	36(35.3)	66(64.7)
重症肺炎组	44	27(61.4)	17(38.6)	4.491±0.863	46.700±14.500	28(63.6)	16(36.4)
统计值		χ²=0.883		t=-1.187	t=1.135	χ²=0.015
P值		0.347		0.237	0.258	0.901

组别	例数	性别[例(%)]		体重(kg)	日龄(日)	湿啰音[例(%)]
组别	例数	男	女	体重(kg)	日龄(日)	有	无
轻症肺炎组	102	54(52.9)	48(47.1)	4.654±0.707	44.200±11.100	36(35.3)	66(64.7)
重症肺炎组	44	27(61.4)	17(38.6)	4.491±0.863	46.700±14.500	28(63.6)	16(36.4)
统计值		χ²=0.883		t=-1.187	t=1.135	χ²=0.015
P值		0.347		0.237	0.258	0.901

组别	例数	LUSS[M(P25,P75)]
轻症肺炎组	102	3.0(1.0, 8.0)
重症肺炎组	44	12.0(6.0, 21.5)
统计值		Z=-6.091
P值		<0.01