肺部超声评分在早产儿呼吸窘迫综合征病情评估中的价值

The value of lung ultrasound score in preterm neonatal respiratory distress syndrome

目的探讨双肺6区肺超声评分法（LUS）联合超声心动图在评价早产儿呼吸窘迫综合征（RDS）严重程度中的价值。方法通过高频超声对临床及胸部X线确诊为RDS的43例早产儿行肺部超声检查，进行超声评分，同时行超声心动图检查，记录三尖瓣反流面积及速度、肺动脉收缩压（PASP）等指标，将LUS与PASP、X线分级进行相关性分析。按照有无动脉导管未闭（PDA）将患儿分为PDA组与无PDA组，比较两组LUS是否存在差异。结果①LUS与PASP呈显著正相关（r=0．647，P〈0．05）；②LUS与X线分级呈显著正相关（r=0．770，P〈0．05），不同X线分级间LUS差异有统计学意义（F=31．460，P〈0．05）；③PDA组LUS明显高于无PDA组（t=3．08，P〈0．05）。结论双肺6区肺超声评分联合超声心动图可有效评估早产儿RDS心肺情况，为临床提供更多参考信息。

Objective To investigate the value of lung ultrasound scores （LUS） combined with echocardiography for evaluation of the state of preterm neonatal respiratory distress syndrome （RDS）. Methods Lung ultrasound and echocardiography were conducted on 43 preterm newborns with RDS. The eehocardiographic parameter included the area and velocity of tricuspid regurgitation, patent ductus arteriosus （PDA） and pulmonary artery systolic pressure （PASP）. Correlational analyses of LUS and PASP,or X-ray grading were conducted. LUS difference was compared between the groups with PDA and without PDA. Results （1） There was positive correlations between LUS and PASP （ r = 0.647, P 〈0.05）,LUS and X-ray grade （ r = 0.770, P 〈0.05）. （2）LUS was significant different in different X-ray grade（ F = 31.460, P 〈0.05）. （3）Significant difference was found between the groups with PDA and without PDA（ t = 3.08, P 〈0.05）. Conclusions LUS combined with echocardiography can be used as an effective method for early diagnosis, condition assessment and prognosis of RDS, and it is more direct, fast and without radiation.