床旁肺超声B线特征在评价急性心源性肺水肿程度及治疗疗效中的作用

Evaluation of characteristics of B line by bedside lung ultrasound in diagnosis and therapeutic effect of acute cardiogenenic pulmonary edema

目的应用床旁肺超声观察急性心源性肺水肿患者肺超声B线特征及其变化,探讨B线在判断临床病变程度及评估治疗效果中的价值。方法选取19例确诊为急性心源性肺水肿的患者,于治疗前和治疗后2周行床旁肺部12区超声检查(左肺6区和右肺6区),比较治疗前后肺超声评分;应用Pearson相关分析法分析B线出现频率(出现B线的肺扫描区个数)与动脉血氧分压(Pa O2)和血浆脑利钠肽(BNP)水平的相关性。结果所有患者均可观察到两肺弥漫性B线,治疗前后肺超声评分比较差异有统计学意义(7.3±2.4 vs.2.1±1.1,P<0.01)。B线出现频率与血浆BNP水平呈正相关(r=0.65),与Pa O2呈负相关(r=-0.73)。结论床旁肺超声B线可有效评估急性心源性肺水肿病变程度和治疗效果。

Objective To observe the characteristics and changes of B line by bedside lung ultrasound in patients with acute cardiogenic pulmonary edema,and to explore the value of B line in evaluating the severity of clinical disease and assessing the effect of treatment.Methods A total of 19 cases confirmed as acute cardiogenic pulmonary edema were selected. The bedside lung ultrasonography was performed on 12 scans of lung(left lung 6 and right lung 6) before and 2 week after treatment,and the lung ultrasound scores were compared before and after treatment. The Pearson correlation analysis was used to analyze the correlation between B-line frequency(the number of appeared lung scans with line B) and the arterial oxygen partial pressure(PaO2) and plasma brain natriuretic peptide(BNP) levels.Results All patients showed diffuse B lines by lung ultrasound,there was significant difference in lung ultrasound scores before and after treatment(7.3±2.4 vs. 2.1±1.1,P<0.01). The frequency of B-line was positively correlated with plasma BNP level(r=0.65) and negatively correlated with PaO2(r=-0.73).Conclusion B line by bedside lung ultrasound can effectively assess the extent of pulmonary edema in patients with acute heart failure and the therapeutic effect.