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囊性纤维化患者的肺部超声评估:呼吸科门诊的一种新方法。

Lung ultrasound evaluation in people with cystic fibrosis: A new approach in the pulmonology outpatient clinic.

作者信息

Curatola Antonietta, Corona Federica, Squillaci Domenica, Saccari Alessia, Chiaretti Antonio, Barbi Egidio, Maschio Massimo

机构信息

Department of Pediatrics, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

University of Trieste, Trieste, Italy.

出版信息

Pediatr Pulmonol. 2024 Mar;59(3):592-599. doi: 10.1002/ppul.26787. Epub 2023 Nov 28.

Abstract

BACKGROUND

Cystic fibrosis (CF) is a genetic disease that causes progressive lung disease with major impact on the quality of life. Lung ultrasound (LUS) allows to assess the lung involvement through the artefacts analysis and is increasingly used in children but is not yet used to monitor people with CF(pwCF). The main aim of this study was to describe the LUS pattern of pwCF during their routinary check-up visit. The secondary objective was to correlate the LUS findings with pulmonary function indices.

METHODS

We performed a cross-sectional observational study, enrolling adolescents and young adults with CF. Each patient underwent clinical assessment, measurement of SpO2, assessment of lung function by spirometry and LUS.

RESULTS

Twenty-nine subjects with CF were included. The most frequent alterations were consolidations (72.4%) located in the left apical anterior and right apical posterior regions followed by interstitial syndrome (65.5%). The 41.4% of cases presented the lingula involvement, characterized by a consolidation with static air bronchogram, and 55.2% showed pleural irregularity mainly in the posterior apical regions. A significant correlation was found between the LUS total score and spirometric indices: FEV (p = .003), FVC (p = .002), Tiffenau Index <80% (p = .014), and FEF 25-75 (p = .004).

CONCLUSIONS

Our study describes LUS findings in pwCF. It also showed a correlation between LUS score and the patients' lung function measured by spirometric indices. We conclude that LUS may be useful in routine monitoring of pwCF in combination with clinical and spirometric assessment.

摘要

背景

囊性纤维化(CF)是一种导致进行性肺部疾病的遗传疾病,对生活质量有重大影响。肺部超声(LUS)可通过伪像分析评估肺部受累情况,在儿童中应用越来越广泛,但尚未用于监测囊性纤维化患者(pwCF)。本研究的主要目的是描述pwCF在常规检查期间的LUS模式。次要目的是将LUS结果与肺功能指标相关联。

方法

我们进行了一项横断面观察性研究,纳入患有CF的青少年和青年成年人。每位患者均接受临床评估、SpO2测量、通过肺活量测定法评估肺功能以及LUS检查。

结果

纳入了29名CF患者。最常见的改变是实变(72.4%),位于左肺尖前部和右肺尖后部区域,其次是间质综合征(65.5%)。41.4%的病例出现舌叶受累,表现为伴有静态空气支气管征的实变,55.2%的病例主要在肺尖后部区域出现胸膜不规则。LUS总分与肺活量测定指标之间存在显著相关性:第一秒用力呼气容积(FEV)(p = 0.003)、用力肺活量(FVC)(p = 0.002)、蒂芬诺指数<80%(p = 0.014)以及用力呼气流量25%-75%(FEF 25-75)(p = 0.004)。

结论

我们的研究描述了pwCF的LUS结果。还显示LUS评分与通过肺活量测定指标测量的患者肺功能之间存在相关性。我们得出结论,LUS结合临床和肺活量测定评估可能对pwCF的常规监测有用。

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