【摘要】 目的探讨合并支气管肺发育不良(BPD)的新生儿呼吸窘迫综合征(NRDS)早产儿的超声评分(LUS)变化及其临床应用价值。方法纳入94例NRDS的早产儿,按照出院时是否合并BPD将其分为BPD组54例和无BPD组40例。于出生后1～2 d以及第1、2、3、4周末,采用床旁肺超声对两组患儿行LUS。比较两组患儿不同时间点的LUS评分,并采用受试者工作特征(ROC)曲线评价不同时间节点LUS评分预测BPD的价值。结果出生后第1、2、3、4周末,BPD组的LUS评分均高于无BPD组(均P<0.05);BPD组不同时间点的LUS评分均>10分,差异无统计学意义(P>0.05),而无BPD组的LUS评分总体呈下降趋势(P>0.05)。出生后1～2 d的LUS评分预测BPD的ROC曲线下面积为0.563(P>0.05),而出生后第1、2、3、4周末LUS评分预测BPD的ROC曲线下面积分别为0.672(P<0.05)、0.723(P<0.05)、0.780(P<0.05)、0.846(P<0.05),敏感性分别为38.9%、57.4%、57.4%、68.5%,特异性分别为80.0%、80.0%、95.0%、90.0%。结论合并BPD的NRDS早产儿从出生1～2 d内到出生后4周的LUS评分呈持续高水平;出生后1～4周LUS评分可以作为预测NRDS早产儿发生BPD的有效指标。更多还原

【Abstract】 Objective To explore the changes of lung ultrasound score(LUS) in neonatal respiratory distress syndrome(NRDS) premature infants complicated with bronchopulmonary dysplasia(BPD) and its clinical application value. Methods Ninety-four NRDS premature infants were divided into BPD group(n=54) and non-BPD group(n=40) according to the occurrence of concomitant BPD at discharge. One to two days after birth, and at the end of the first, second, third and fourth week after birth, LUS was performed in both groups by using bedside lung ultrasound. LUS scores at different time points were compared between the two groups, and receiver operating characteristic(ROC) curve was employed to assess the value of LUS scores at different time points for predicting BPD. Results At the end of the first, second, third or fourth week after birth, LUS score in the BPD group was higher than that in the non-BPD group(all P<0.05); LUS scores at different time points were higher than 10 in the BPD group, but showed no statistically significant difference(P>0.05), and LUS score tended to decrease generally in the non-BPD group(P<0.05). One to two days after birth, and at the end of the first, second, third and fourth week after birth, LUS scores yielded the areas under ROC curve of 0.563(P>0.05), 0.672(P<0.05), 0.723(P<0.05), 0.780(P<0.05) and 0.846(P<0.05), respectively, with the sensitivities of 38.9%, 57.4%, 57.4% and 68.5%, respectively, and the specificities of 80.0%, 80.0%, 95.0% and 90.0%, respectively, for predicting BPD. Conclusion LUS score of NRDS premature infants complicated with BPD is on the rise from days 1 to 2 postnatally to week 4 postnatally; LUS score during week 1 to week 4 can be used as an effective marker to predict the occurrence of BPD in NRDS premature infants.更多还原