肺部超声B线数目与血管外肺水及ARDS严重程度的相关性分析

目的 评估急性呼吸窘迫综合征（ARDS）患者的B线评分与脉波指示连续心排血法（PiCCO）所测血管外肺水（EVLW）及氧合指数的相关性,探讨肺部超声（LUS）对肺水的监测价值,从而为监测ARDS患者EVLW提供动态有效的方法 .方法在ARDS患者治疗过程中应用LUS动态监测B线数目,同时应用PiCCO监测血管外肺水指数（EVLWI）,对比B线数目和EVLWI进行Pearson相关行分析.结果 共纳入19例患者,采集171组数据,B线数目与EVLWI呈正相关（r=0.849,P〈0.001）.B线数目与PaO2/FiO2呈高度负相关（r=-0.757,P〈0.001）.以PiCCO计算所得EVLWI≥10ml/kg为阳性,对LUS检测方法绘制ROC曲线,LUS检测的曲线下面积是0.957,敏感度82%,特异度95.3%.结论 LUS B线数目与EWLWI呈高度正相关、与PaO2/FiO2呈负相关,且随着ARDS的加重,B线数目增多.在诊断急性肺水肿中,LUS具有较高的敏感度和特异度.

Objective To evaluate the correlation between B score and EVLW and oxygenation index in patients with ARDS,and to explore the value of lung ultrasound in monitoring the lung water,so as to provide a dynamic and effective method for monitoring PiCCO patients with EVLW. Methods The application of the number of lung ultrasound dynamic monitoring of B line in ARDS patients during the treatment,comparison of the application of pulse indicator continuous cardiac blood monitoring EVLWI,Pearson correlation analysis for the number of B lines and EVLWI. Results A total of 19 patients were enrolled,and the data of the 171 groups were collected. The number of B line was positively correlated with EVLWI（r=0.849,P〈0.001）. The number of B lines was negatively correlated with PaO2/FiO2（r=-0.757,P〈0.001）. The PiCCO calculated EVLWI=10ml / kg were positive on LUS detection method of ROC curve,the 0.957 was the area under the curve of LUS detection,the sensitivity was 82%,specificity was 95.3%. Conclusions The number of B line is positively correlated with the height of EVLWI,and the measurement of B line in the early stage of LUS can better diagnose lung water. Therefore,LUS is an important method to monitor ARDS,which is non-invasive,economical, simple,rapid,repeatable and non radioactive.