[1]王卫卫,张红伟,崔清洋,等.肺部12分区超声评分法在新生儿呼吸窘迫综合征中的应用价值[J].新乡医学院学报,2022,39(3):252-257.[doi:10.7683/xxyxyxb.2022.03.011]
　WANG Weiwei,ZHANG Hongwei,CUI Qingyang,et al.Application value of lung 12 zone ultrasound score in evaluating neonatal respiratory distress syndrome[J].Journal of Xinxiang Medical University,2022,39(3):252-257.[doi:10.7683/xxyxyxb.2022.03.011]
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肺部12分区超声评分法在新生儿呼吸窘迫综合征中的应用价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年3
页码:
252-257
栏目:
临床研究
出版日期:
2022-03-05

文章信息/Info

Title:
Application value of lung 12 zone ultrasound score in evaluating neonatal respiratory distress syndrome
作者:
王卫卫1; 张红伟2; 崔清洋1; 孔　岩3; 石计朋1; 孙亚洲1; 唐成和1
（1.新乡医学院第一附属医院新生儿科，河南　卫辉　453100；2.新乡医学院第一附属医院麻醉科，河南　卫辉　453100；3.新乡医学院第一附属医院超声科，河南　卫辉　453100）
Author(s):
WANG Weiwei1; ZHANG Hongwei2; CUI Qingyang1; KONG Yan3; SHI Jipeng1; SUN Yazhou1; TANG Chenghe1
(1.Department of Neonatology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;2.Department of Anesthesiology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China;3.Department of Ultrasonography,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
新生儿; X线检查; 超声检查; 肺部12分区法; 呼吸窘迫综合征
Keywords:
newborns; X-ray examination; ultrasonic examination; lung 12 zone ultrasound score; respiratory distress syndrome
分类号:
R725.6
DOI:
10.7683/xxyxyxb.2022.03.011
文献标志码:
A
摘要:
目的　探讨肺部12分区超声评分法评价新生儿呼吸窘迫综合征（NRDS）患儿病情严重程度的临床应用价值。方法　选择2018年10月至2020年1月出生24 h内因NRDS入住新乡医学院第一附属医院新生儿科的77例NRDS患儿为研究对象。所有入组患儿均行肺部超声及X线检查，应用血气分析仪进行氧合指数检测，并进行新生儿呼吸窘迫评分、新生儿危重病例评分。应用Spearman分析肺部12分区超声评分与X线分级的相关性，比较Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级患儿肺部12分区超声评分的差异，应用受试者工作特征（ROC）曲线预测肺部12分区超声评分对NRDS分级的截断值、特异度及敏感度；应用Pearson分析肺部12分区超声评分法与新生儿呼吸窘迫评分、氧合指数、新生儿危重病例评分的相关性。结果　77例NRDS新生儿肺部12分区超声评分为（19.47±6.00）分，其中X线分级Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级NRDS患儿肺部12分区超声评分分别为（12.86±3.76）、（19.11±2.22）、（25.36±1.80）、（29.88±1.36）分；Ⅱ级、Ⅲ级、Ⅳ级NRDS患儿肺部超声评分显著高于Ⅰ级NRDS患儿，Ⅲ级、Ⅳ级NRDS患儿肺部超声评分显著高于Ⅱ级NRDS患儿，Ⅳ级NRDS患儿肺部超声评分显著高于Ⅲ级NRDS患儿(P<0.05)。Spearman分析显示，肺部12分区超声评分与X线分级呈正相关（r=0.742，P<0.05）。肺部12分区超声评分以14.5分为截断值，鉴别诊断X线分级Ⅰ级与Ⅱ级的敏感度为0.946，特异度为0.714，ROC曲线下面积（AUC）为0.882；肺部12分区超声评分以23.0分为截断值，鉴别诊断X线分级Ⅱ级与Ⅲ级的敏感度为0.818，特异度为0.757，AUC为0.875；肺部12分区超声评分以29.5分为截断值，鉴别诊断X线分级Ⅲ级与Ⅳ级的敏感度为0.750，特异度为0.818，AUC为0.858。肺部12分区超声评分与氧合指数呈负相关（r=-0.827，P<0.05）。中度呼吸窘迫组患儿肺部12分区超声评分显著高于轻度呼吸窘迫组，重度呼吸窘迫组患儿肺部12分区超声评分显著高于中度呼吸窘迫组及轻度呼吸窘迫组(P<0.05)。肺部12分区超声评分与新生儿呼吸窘迫评分呈正相关（r=0.917，P<0.05）。极危重组患儿肺部12分区超声评分显著高于危重症组，危重症组患儿肺部12分区超声评分显著高于非危重症组(P<0.05）。肺部12分区超声评分与危重症评分呈负相关（r=-0.799，P<0.05）。结论　肺部12分区超声评分可预测NRDS患儿病情的严重程度，在NRDS患儿病情评估中具有较高的临床应用价值。
Abstract:
Objective　To explore the clinical value of lung 12 zone ultrasound score in evaluating the severity of neonatal respiratory distress syndrome(NRDS).Methods　A total of 77 children with NRDS admitted to the Department of Neonatology,the First Affiliated Hospital of Xinxiang Medical University due to NRDS within 24 hours after birth from October 2018 to January 2020 were selected as the research objects.All the enrolled children were underwent pulmonary ultrasound and X-ray examination,oxygenation index was detected by using blood gas analyzer,and the neonatal respiratory distress score and neonatal critical case score were performed.Spearman analysis was used to analyze the correlation between lung 12 zone ultrasound score and X-ray grade,and the differences of lung 12 zone ultrasound score among the children with grade Ⅰ,Ⅱ,Ⅲ and Ⅳ were compared;receiver operating characteristic (ROC) curve was used to predict the cutoff point,specificity and sensitivity of lung 12 zone ultrasound score in evaluating the severity of NRDS;the correlation between lung 12 zone ultrasound score and neonatal respiratory distress score,oxygenation index and neonatal critical case score was analysed by Pearson.Results　The lung 12 zone ultrasound score of 77 newborns with NRDS was 19.47 ± 6.00,of which the lung 12 zone ultrasound score of children with X-ray grade Ⅰ,Ⅱ,Ⅲ and Ⅳ of NRDS was 12.86±3.76,19.11±2.22,25.36±1.80,29.88±1.36,respectively;the lung 12 zone ultrasound score of children with X-ray grade Ⅱ,Ⅲ and Ⅳ of NRDS was significantly higher than that of children with X-ray grade Ⅰ of NRDS,and the lung 12 zone ultrasound score of children with X-ray grade Ⅲ and Ⅳ of NRDS was significantly higher than that of children with X-ray grade Ⅱ of NRDS,and the lung 12 zone ultrasound score of children with X-ray grade Ⅳ of NRDS was significantly higher than that of children with X-ray grade Ⅲ of NRDS(P<0.05).Spearman analysis showed that there was a positive correlation between the lung 12 zone ultrasound score and X-ray grade (r=0.742,P<0.05).The cutoff value of lung 12 zone ultrasound score was 14.5,and the sensitivity and specificity of differential diagnosis of X-ray grade Ⅰ and Ⅱ were 0.946 and 0.714,and the ROC area under curve (AUC) was 0.882;the cutoff value of lung 12 zone ultrasound score was 23.0,and the sensitivity,specificity and AUC of differential diagnosis of X-ray grade Ⅱ and Ⅲ were 0.818,0.757 and 0.875,respectively;the cutoff value of lung 12 zone ultrasound score was 29.5,and the sensitivity,specificity and AUC of differential diagnosis of X-ray grade Ⅲ and Ⅳ were 0.750,0.818 and 0.858,respectively.There was a negative correlation between lung 12 zone ultrasound score and oxygenation index(r=-0.827,P<0.05).The lung 12 zone ultrasound score in the moderate respiratory distress group was significantly higher than that in the mild respiratory distress group,the lung 12 zone ultrasound score in the severe respiratory distress group was significantly higher than that in the moderate respiratory distress group and mild respiratory distress groups (P<0.05).The respiratory distress was positively correlated with the neonatal respiratory distress score (r=0.917,P<0.05).The lung 12 zone ultrasound score of children in the extremely critical illness group was significantly higher than that in the critical illness group,the lung 12 zone ultrasound score of children in the critical illness group was significantly higher than that in the non-critical illness group(P<0.05).The lung 12 zone ultrasound score was negatively correlated with the neonatal critical illness score (r=-0.799,P<0.05).Conclusion　The lung 12 zone ultrasound score can predict the severity of NRDS,and which has high clinical value in the evaluation of NRDS.

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更新日期/Last Update: 2022-03-05