Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA.
Clin Transplant. 2012 Sep-Oct;26(5):665-71. doi: 10.1111/j.1399-0012.2011.01591.x. Epub 2012 Feb 10.
Quantification of the degree of pulmonary edema in organ donors is useful for assessing the clinical severity of pulmonary edema, determining response to therapy, and as an endpoint for therapeutic trials. Currently, there is no accurate non-invasive method for assessing the degree of pulmonary edema. We tested the performance of a four-quadrant chest radiographic scoring system compared to quantification of pulmonary edema by excised lung weight in 84 donors whose lungs were not used for transplantation. Chest radiographs were taken 3.6 ± 3.0 h prior to organ procurement and were scored by two of the authors. Lungs were excised without perfusion and individually weighed. The chest radiographic scoring system had good performance: correlation between total radiographic score and total lung weight of 0.61, p < 0.001. Performance of the scoring system was improved when chest radiographs with atelectasis were excluded (r = 0.79, p < 0.001). The area under the receiver operator characteristic curve for the detection of moderate pulmonary edema (total lung weight >1000 g) was 0.80. This chest radiographic scoring system may potentially be used to assess the clinical severity of pulmonary edema and may be useful as part of the evaluation of donors for suitability for lung transplantation.
对器官捐献者肺水肿程度进行量化对于评估肺水肿的临床严重程度、确定治疗反应以及作为治疗试验的终点非常有用。目前，尚无准确的非侵入性方法来评估肺水肿的程度。我们测试了一种四象限胸部 X 线摄影评分系统与切除肺重量评估 84 例未用于移植的捐献者肺水肿程度的性能。胸部 X 射线在器官采集前 3.6 ± 3.0 小时拍摄，并由两位作者进行评分。肺在不灌注的情况下被切除并单独称重。该 X 线摄影评分系统具有良好的性能：总 X 线摄影评分与总肺重量之间的相关性为 0.61，p < 0.001。当排除存在肺不张的 X 射线照片时，评分系统的性能得到改善（r = 0.79，p < 0.001）。检测中重度肺水肿（总肺重量>1000 克）的受试者工作特征曲线下面积为 0.80。这种 X 射线摄影评分系统可能可用于评估肺水肿的临床严重程度，并可作为评估供体是否适合肺移植的评估的一部分。
