Yuksel B, Greenough A, Karani J
Department of Child Health, King's College Hospital, London, UK.
Br J Radiol. 1992 Dec;65(780):1083-5. doi: 10.1259/0007-1285-65-780-1083.
The aim of this study was to assess if quantitative classification of the chest radiograph appearance at 7 days predicted chronic oxygen dependency (oxygen dependency beyond 8 weeks of age) more accurately than did subjective classification at 28 days of age. Thirty preterm infants, median gestational age 27 weeks, who had chest radiographs taken for clinical purposes at 7 and 28 days of age, were recruited into the study. The 7-day chest radiograph was scored according to the lung volume, presence of opacification, interstitial changes, pulmonary interstitial emphysema and cystic elements. The range of chest radiograph scores was from 0-18, a score of 18 indicating the most abnormal appearance. The 28-day chest radiograph was classified as Type I or Type II chronic lung disease (CLD), according to the presence or absence, respectively, of coarse reticulation. The median chest radiograph score at 7 days of the 30 infants was 5 (range 2-14). In predicting chronic oxygen dependency, a chest radiograph score of 5 at 7 days had 83% sensitivity and 75% specificity, but a diagnosis of Type II CLD at 28 days of age had only 67% sensitivity and 67% specificity. We conclude that a quantitative assessment of the chest radiograph appearance at 7 days is more useful than a subjective assessment at 28 days of age.
本研究的目的是评估出生7天时胸部X光片表现的定量分类是否比出生28天时的主观分类更准确地预测慢性氧依赖（8周龄后仍需氧依赖）。30名孕周中位数为27周的早产儿被纳入研究，他们在出生7天和28天时因临床需要拍摄了胸部X光片。根据肺容积、有无肺实变、间质改变、肺间质气肿和囊性成分对出生7天的胸部X光片进行评分。胸部X光片评分范围为0至18分，18分表示最异常的表现。根据有无粗网状影，将出生28天的胸部X光片分为I型或II型慢性肺病（CLD）。30名婴儿出生7天时胸部X光片评分的中位数为5分（范围2至14分）。在预测慢性氧依赖方面，出生7天时胸部X光片评分为5分的敏感度为83%，特异度为75%，而出生28天时诊断为II型CLD的敏感度仅为67%，特异度为67%。我们得出结论，出生7天时对胸部X光片表现进行定量评估比出生28天时的主观评估更有用。
