肺超声彗星尾征对急性呼吸窘迫综合征血管外肺水判定与评估

发布时间：2018-04-01 23:27

本文选题：急性呼吸窘迫综合征　切入点：肺超声彗星尾　出处：《中国实用内科杂志》2017年08期

【摘要】：目的探索肺超声评分(LUS)判定血管外肺水指数(EVLW)的敏感度和特异度。方法入选2012年6月至2014年12月首都医科大学附属复兴医院重症医学科连续收治的急性呼吸窘迫综合征(ARDS)患者21例,于入ICU第1个24 h内记录患者一般临床特征,完善胸部CT检查,并于入ICU第1、2、3天分别行床旁X线胸片、肺超声及判定与脉搏指示持续心排量监测(PiCCO)3者检查时间相隔2 h;同时设立非ARDS患者为对照组,于24h内完成肺超声、胸部CT及胸片检查。结果 LUS与PiCCO测定的EVLWI呈显著线性相关(r=0.927,P0.01);LUS与X线胸片评分之间呈显著正相关(r=0.720,P0.01)。肺超声判定ELVW的ROC曲线下面积为0.924(P0.01),cut-off值为12.5,其敏感度和特异度分别为0.857和0.600;床旁X线胸片判定ELVW的ROC曲线下面积为0.732(P=0.019),cut-off值为14.0,其敏感度和特异度分别为0.619和0.667。结论 LUS具有较高的敏感度和特异度及可重复性用以定性及定量判定ARDS患者EVLW。
[Abstract]:Objective to explore the lung ultrasound score (LUS) to determine the extravascular lung water index (EVLW) sensitivity and specificity. Methods the acute respiratory ICU of Fuxing Hospital Affiliated to Captial Medical University from June 2012 to December 2014 from distress syndrome (ARDS) patients with 21 cases, the first ICU within 24 h records of patients with general clinical characteristics, improve the chest CT examination, and were performed on ICU day 1,2,3 bedside chest X-ray, lung ultrasound and determination and pulse indicator continuous cardiac output monitoring (PiCCO) 3 check time separated by 2 h; and the establishment of non ARDS patients as the control group, the lung ultrasound in 24h, CT and chest X-ray examination. The results showed a significant linear correlation LUS and PiCCO determination of EVLWI (r=0.927, P0.01); there was a significant positive correlation between LUS and chest X-ray score (r=0.720, P0.01). Lung ultrasound criteria ROC area under the ELVW curve was 0.924 (P0.01), cut-off value was 12.5, the sensitivity Sensitivity and specificity were 0.857 and 0.600; bedside chest X-ray determination ROC area under the ELVW curve was 0.732 (P=0.019), cut-off value was 14, the sensitivity and specificity were 0.619 and 0.667. respectively. Conclusion: LUS has high sensitivity and specificity and can be qualitative and quantitative determination of ARDS in patients with EVLW. with repetition

【作者单位】：首都医科大学附属复兴医院;
【基金】：基金项目:首都临床特色应用研究(Z121107001012125)
【分类号】：R445.1;R563.8

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