改良肺超声评分评估支气管肺发育不良的短期临床结局。
A modified lung ultrasound score to evaluate short-term clinical outcomes of bronchopulmonary dysplasia.
机构信息
Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
Department of Ultrasound, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
出版信息
BMC Pulm Med. 2022 Mar 19;22(1):95. doi: 10.1186/s12890-022-01885-4.
BACKGROUND
Lung ultrasound (LUS) is a useful tool for assessing the severity of lung disease, without radiation exposure. However, there is little data on the practicality of LUS in assessing the severity of bronchopulmonary dysplasia (BPD) and evaluating short-term clinical outcomes. We adapted a LUS score to evaluate BPD severity and assess the reliability of mLUS score correlated with short-term clinical outcomes.
METHODS
Prospective diagnostic accuracy study was designed to enroll preterm infants with gestational age < 34 weeks. Lung ultrasonography was performed at 36 weeks postmenstrual age. The diagnostic and predictive values of new modified lung ultrasound (mLUS) scores based on eight standard sections were compared with classic lung ultrasound (cLUS) scores.
RESULTS
A total of 128 infants were enrolled in this cohort, including 30 without BPD; 31 with mild BPD; 23 with moderate BPD and 44 with severe BPD. The mLUS score was significantly correlated with the short-term clinical outcomes, superior to cLUS score. The mLUS score well correlated with moderate and severe BPD (AUC = 0.813, 95% CI 0.739-0.888) and severe BPD (AUC = 0.801, 95% CI 0.728-0.875), which were superior to cLUS score. The ROC analysis of mLUS score to evaluate the other short-term outcomes also showed significant superiority to cLUS score. The optimal cutoff points for mLUS score were 14 for moderate and severe BPD and 16 for severe BPD.
CONCLUSIONS
The mLUS score correlates significantly with short-term clinical outcomes and well evaluates these outcomes in preterm infants.
背景
肺部超声（LUS）是一种评估肺部疾病严重程度的有用工具，且不会受到辐射暴露的影响。然而，关于 LUS 在评估支气管肺发育不良（BPD）严重程度和评估短期临床结局方面的实用性，数据较少。我们对 LUS 评分进行了调整，以评估 BPD 的严重程度，并评估与短期临床结局相关的 mLUS 评分的可靠性。
方法
设计了一项前瞻性诊断准确性研究，纳入胎龄 <34 周的早产儿。在校正月龄 36 周时进行肺部超声检查。比较了基于 8 个标准节段的新型改良肺部超声（mLUS）评分与经典肺部超声（cLUS）评分的诊断和预测价值。
结果
共纳入 128 例婴儿，其中 30 例无 BPD，31 例轻度 BPD，23 例中度 BPD，44 例重度 BPD。mLUS 评分与短期临床结局显著相关，优于 cLUS 评分。mLUS 评分与中重度 BPD（AUC=0.813，95%CI 0.739-0.888）和重度 BPD（AUC=0.801，95%CI 0.728-0.875）相关性较好，优于 cLUS 评分。mLUS 评分评估其他短期结局的 ROC 分析也显示出显著优势。mLUS 评分评估中重度和重度 BPD 的最佳截断值分别为 14 和 16。
结论
mLUS 评分与短期临床结局显著相关，能很好地评估早产儿的这些结局。
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