肺部超声评分在急性呼吸窘迫综合征患者预后及病情严重程度中的评估价值

Evaluation Value of Pulmonary Ultrasound Score in Prognosis and Severity of Acute Respiratory Distress Syndrome

[目的]探讨肺部超声(LUS)评分在急性呼吸窘迫综合征(ARDS)患者预后及病情严重程度中的评估价值.[方法]选取2018年1月至2019年1月在本院呼吸内科诊治的ARDS患者103例,根据柏林2012年ARDS病情标准分为轻度组11例,中度组43例,重度组49例;再根据预后分为存活组72例,死亡组31例.所有患者均于入院当天行LUS检查和动脉血气分析,并采用急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分评价预后并比较.采用逐步线性回归分析LUS评分与预后及病情严重程度的相关性.[结果]存活组患者LUS评分、APACHEⅡ评分分别为(15.71±2.31)分、(13.69±2.06)分,均显著低于死亡组的(23.77±4.82)分、(24.73±3.94)分,其差异均有统计学意义(t=11.726,P<0.001;t=10.861,P<0.001).轻、中、重度组LUS评分、呼气末正压通气(PEEP)依次升高;氧合指数(PaO2/FiO2)依次降低,组间比较差异均有统计学意义(P<0.05).逐步线性回归分析显示:LUS评分与预后及病情严重程度呈正相关.[结论]LUS评分与ARDS患者预后及病情严重程度呈正相关,可作为评估ARDS患者病情和预后的重要辅助指标.

[Objective]To evaluate the value of pulmonary ultrasound(LUS)score in the prognosis and severity of acute respiratory distress syndrome(ARDS).[Methods]From January 2018 to January 2019,103 patients with ARDS who were diagnosed and treated in the respiratory department of our hospital were divided into mild group(11 cases),moderate group(43 cases)and severe group(49 cases)according to the Berlin standard of ARDS in 2012,and then divided into survival group(72 cases)and death group(31 cases)according to the prognosis.All patients underwent LUS and arterial blood gas analysis on the day of admission,and the prognosis was evaluated by acute physiology and APACHEⅡ.The correlation between LUS score,prognosis and severity of the disease was analyzed by stepwise linear regression.[Results]The scores of LUS and Apache Ⅱ in the survival group were(15.71±2.31)and(13.69±2.06)respectively,which were significantly lower than those in the death group(23.77±4.82)and(24.73±3.94).The differences were statistically significant(t=11.726,P<0.001;t=10.861,P<0.001).The scores of LUS,peep and PaO2/FiO2 in mild,moderate and severe groups increased in turn,and the differences between the two groups were statistic8ally significant(P<0.05).Stepwise linear regression analysis showed that LUS score was positively correlated with prognosis and severity of the disease.[Conclusion]LUS score has a positive correlation with the prognosis and severity of the patients with ARDS,which can be used as an lmportant auxlary index to evaluate the con-dition and prognosis of the patients with ARDS.