改良版肺超声评分法对比胸片定量评估新生儿呼吸窘迫综合征严重程度

An modified ultrasound score for quantitative comparison with chest X-ray to assess the severity of neonatal respiratory distress syndrome

目的:通过对比新生儿呼吸窘迫综合征(NRDS)患儿的胸片结果,探讨改良版肺超声评分法定量评估NRDS患儿病情严重程度的效能及价值。方法:选取临床诊断为NRDS的患儿23例(病例组)和临床诊断无肺部疾病的患儿30例(对照组)。病例组患儿均行胸片检查及改良版肺超声评分。病例组胸片检查及超声评分均为40次(包括复查病例),对照组行超声评分30次。比较病例组与对照组的超声评分。对病例组的超声评分与NRDS的严重程度进行相关性分析。病例组依据胸片分级分为4组,通过绘制受试者工作特征(ROC)曲线,分析超声评分的诊断效能并得出各组间截断值。结果:病例组和对照组的超声评分分别为(16.3±9.6)分、(0.5±0.8)分,病例组肺超声评分显著高于对照组,差异有统计学意义(P<0.05)。相关性分析结果显示,病例组肺超声评分与NRDS的严重程度存在正相关关系且相关性显著(r=0.635,P<0.01)。ROC曲线分析结果显示,病例组各组间超声评分截断值分别为10.5、18.5、25.5,曲线下面积分别为0.877、0.891、0.920,对应约登指数为0.688、0.680、0.796,敏感度为0.813、0.800、0.857,特异度为0.875、0.880、0.939。结论:改良版肺超声评分法可定量评估新生儿呼吸窘迫综合征的严重程度,并且分数越高病情越严重。

Objective:The ability and value of a modified lung ultrasound scoring to assess the severity of the disease in children with neonatal respiratory distress syndrome(NRDS)were discussed and compared the results with chest X-ray in children with(NRDS).Methods:In the neonatal ward,23 children with clinical diagnosis of NRDS(case group)and 30 children without lung disease(normal group)were selected.All children in the case group underwent chest radiography and modified lung ultrasound score.Chest X-ray and ultrasound scores were both performed 40 times in the case group(including re-examination cases),and 30 ultrasound scores were performed in the control group.The ultrasound scores of the case group and the control group were compared.The correlation between the severity of NRDS and the ultrasonic score of the case group was analyzed.Case group were divided into four groups based on chest X-ray grading.By drawing the receiver operating characteristic(ROC)curve,the diagnostic efficacy of ultrasound scoring was analyzed and the cutoff values between each group were obtained.Results:The ultrasound scores of the case and control groups were(16.3±9.6)and(0.5±0.8)respectively.Pulmonary ultrasonic score in case group was significantly higher than that in control group,the difference was statistically significant(P<0.05).The results of the correlation analysis showed a positive correlation between the lung ultrasound score and NRDS severity in the case group(r=0.635,P<0.01).ROC curve analysis showed that the cut-off value of ultrasonic score between each group in the case group was 10.5,18.5,25.5,the area under curve was 0.877,0.891,0.92,the corresponding Youden index was 0.688,0.68,0.796,and the sensitivity was 0.813,0.800,0.857,respectively.The specificity was 0.875,0.880,0.939,respectively.Conclusion:The modified lung ultrasound scoring method can quantitatively evaluate the severity of neonatal respiratory distress syndrome,and the higher the score,the more severe the disease.