早产儿肺脏的超声特征及超声评分

Ultrasonographic features and significance of scoring of lung in preterm infants

目的观察早产儿肺脏的超声表现和超声评分。方法选取无心肺疾病及低蛋白血症的早产儿37例(早产儿组)及足月儿33例(足月儿组),并根据患儿年龄将每组分为<1周、1～4周、>4周3个亚组。对所有患儿行双肺超声检查并予以评分,观察早产儿肺脏超声表现,比较早产儿与足月儿及不同年龄间的超声评分差异。结果早产儿肺脏超声主要表现为弥漫分布密集B线,伴或不伴"瀑布征",提示肺泡内积液。早产儿及足月儿肺部超声评分结果分别为(15.24±2.76)分和(12.21±3.62)分,差异有统计学意义(t=3.962,P<0.001);年龄<1周的早产儿与足月儿超声评分差异无统计学意义(t=-0.669,P=0.513),年龄为1～4周及>4周的早产儿与足月儿超声评分差异均有统计学意义(P均<0.05)。早产儿3个亚组间肺超声评分差异无统计学意义(F=0.960,P=0.393);足月儿3个亚组间肺超声评分差异有统计学意义(F=4.277,P=0.023)。早产儿肺超声评分与胎龄呈负相关(r=-0.352,P=0.033),其线性回归关方程为Y=33.805-0.548 X。结论早产儿肺脏超声主要表现为弥漫分布密集B线,伴或不伴"瀑布征",提示肺泡内积液,胎龄越小越显著。

Objective To observe ultrasonographic features and significance of scoring of the lung in preterm infants.Methods Totally 37 preterm infants（preterm group）and 33 term infants（term group）without cardiopulmonary disease nor hypoproteinemia were enrolled,and infants in each group were divided into1 week,1—4 weeks and 4 weeks subgroup,respectively.All the infants underwent lung ultrasonography and scoring.The ultrasonography scores were compared between preterm infants and term infants among different ages.Results The main ultrasonic manifestations of the lung in preterm infants were diffuse distribution of dense B-lines,with or without ＂ falls sign＂ suggesting alveolar effusion.The ultrasonographic score of the lung in preterm infants and term infants was（15.24±2.76）and（12.21±3.62）,respectively（t=3.962,P〈0.001）.There was no statistical difference of ultrasonographyic scores in 1 week subgroups between preterm infants and term infants（t=-0.669,P=0.513）.There were statistical differences of ultrasonographic scores in 1-4 weeks subgroups and 4 weeks subgroups between preterm group and term group（both P〈0.05）.In preterm group,the ultrasonographic scores demonstrated no statistical difference among 3 subgroups（F=0.960,P=0.393）,whereas statistical difference was found among 3 subgroups in term group（F=4.277,P=0.023）.The ultrasonographic score of preterm infants showed negative correlation with gestational age（r=-0.352,P=0.033）,and the linear regressive equation was Y=33.805-0.548 X.Conclusion The main ultrasonic manifestations of the lung in preterm infants were diffuse distribution of dense B-lines,some with ＂falls sign＂ suggesting alveolar effusion,which are more significant in smaller gestational age infants.