肺部超声B线数目与血管外肺水的相关性分析

Correlation between B-line score in ultrasonic imaging and extravascular lung water index

目的探讨肺部超声监测B线数目在老年脓毒症患者液体复苏过程中评估血管外肺水的价值。方法在老年脓毒症患者液体复苏过程中应用肺部超声动态监测患者双侧胸骨旁、锁骨中线、腋前线及腋中线B线数目,同时应用脉波指示剂连续心排血量法(pulse indicator continuous cardiac output,PiCCO)监测血管外肺水指数(extravascular lung water index,EVLWI)对比,对B线数目与EVLWI进行Pearson相关性分析。结果共纳入28例患者,采集95组数据,B线数目和EVLWI呈正相关(r=0.92,P<0.01),同时发现B线数目与肺血管通透性指数(pulmonary vascular penetration index,PVPI)呈正相关(r=0.80,P<0.01)。结论B线数目与EVLWI相关性良好,在老年脓毒症液体复苏过程中应用无创肺部超声可实时、动态地进行肺水监测,以早期发现肺水肿。

Objective To assess the correlation of lung ultrasonic B-line score with the extravascular lung water in elderly septic patients with fluid resuscitation. Methods Twenty eight elderly patients with sepsis receiving fluid resuscitation were enrolled in the study. The extravascular lung water index （EVLWl） was determined by pulse indicator continuous cardiac output （PiCCO） system; and the sum of B lines were obtained from echo scanning （right and left hemithorax, from parasternal to mid-axillary line） dynamically. Results The sum of B lines on sonographic images was positively correlated with EVLWl （r=0.92, P〈0.01）, and pulmonary vascular penetration index （PVPI） （r=0.80, P〈0.01）. Conclusion The presence of positive linear correlations between B-lines and EVLWl indicates that lung ultrasonography may be used for monitoring extravascular lung water in elderly septic patients dynamically to avoid fluid overload and lung edema.