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肺部超声能否作为社区获得性肺炎儿童的诊断和监测工具?与风险因素、临床指标及生物学结果的相关性

Can Lung Ultrasound Act as a Diagnosis and Monitoring Tool in Children with Community Acquired Pneumonia? Correlation with Risk Factors, Clinical Indicators and Biologic Results.

作者信息

Isac Raluca, Cugerian-Ratiu Alexandra-Monica, Micsescu-Olah Andrada-Mara, Bodescu Alexandra Daniela, Vlad Laura-Adelina, Zaroniu Anca Mirela, Gafencu Mihai, Doros Gabriela

机构信息

Department of Pediatrics, IIIrd Pediatric Clinic, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.

Emergency Hospital for Children "Louis Țurcanu", Iosif Nemoianu Street 2, 300011 Timisoara, Romania.

出版信息

J Clin Med. 2025 Jul 27;14(15):5304. doi: 10.3390/jcm14155304.

DOI:10.3390/jcm14155304
PMID:40806926
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12347390/
Abstract

Community-acquired pneumonia (CAP) is the leading cause of mortality in children from middle- to low-income countries; diagnosing CAP includes clinical evaluation, laboratory testing and pulmonary imaging. Lung ultrasound (LUS) is a sensitive, accessible, non-invasive, non-radiant method for accurately evaluating the lung involvement in acute diseases. Whether LUS findings can be correlated with CAP's severity or sepsis risk remains debatable. This study aimed to increase the importance of LUS in diagnosing and monitoring CAP. We analyzed 102 children aged 1 month up to 18 years, hospital admitted with CAP. Mean age was 5.71 ± 4.85 years. Underweight was encountered in 44.11% of children, especially below 5 years, while overweight was encountered in 11.36% of older children and adolescents. Patients with CAP presented with fever (79.41%), cough (97.05%), tachypnea (18.62%), respiratory failure symptoms (20.58%), chest pain (12.74%) or poor feeding. Despite the fact that 21.56% had clinically occult CAP and six patients (5.88%) experienced radiologically occult pneumonia, CAP diagnosis was established based on anomalies detected using LUS. Detailed clinical examination with abnormal/modified breath sounds and/or tachypnea is suggestive of acute pneumonia. LUS is a sensitive diagnostic tool. A future perspective of including LUS in the diagnosis algorithm of CAP should be taken into consideration.

摘要

社区获得性肺炎(CAP)是中低收入国家儿童死亡的主要原因;CAP的诊断包括临床评估、实验室检查和肺部影像学检查。肺部超声(LUS)是一种敏感、可及、无创、无辐射的方法,用于准确评估急性疾病时肺部受累情况。LUS检查结果是否与CAP的严重程度或脓毒症风险相关仍存在争议。本研究旨在提高LUS在CAP诊断和监测中的重要性。我们分析了102例年龄在1个月至18岁之间因CAP入院的儿童。平均年龄为5.71±4.85岁。44.11%的儿童体重过轻,尤其是5岁以下儿童,而11.36%的大龄儿童和青少年超重。CAP患者表现为发热(79.41%)、咳嗽(97.05%)、呼吸急促(18.62%)、呼吸衰竭症状(20.58%)、胸痛(12.74%)或喂养困难。尽管21.56%的患者临床上为隐匿性CAP,6例患者(5.88%)有放射学隐匿性肺炎,但基于LUS检测到的异常建立了CAP诊断。伴有异常/改变的呼吸音和/或呼吸急促的详细临床检查提示急性肺炎。LUS是一种敏感的诊断工具。应考虑将LUS纳入CAP诊断算法的未来前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/fcc1757e77ec/jcm-14-05304-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/3dcc2f443c7c/jcm-14-05304-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/690c223890d0/jcm-14-05304-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/b4a8437f051e/jcm-14-05304-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/d674db86ad13/jcm-14-05304-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/fcc1757e77ec/jcm-14-05304-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/3dcc2f443c7c/jcm-14-05304-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/690c223890d0/jcm-14-05304-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/b4a8437f051e/jcm-14-05304-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/d674db86ad13/jcm-14-05304-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a1f/12347390/fcc1757e77ec/jcm-14-05304-g005.jpg

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Diagnostics (Basel). 2024 Dec 12;14(24):2793. doi: 10.3390/diagnostics14242793.
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Clinical, Biological, and Radiological Findings and Management of Lower Respiratory Tract Infections in a Tertiary Hospital in Romania.罗马尼亚一家三级医院下呼吸道感染的临床、生物学和放射学检查结果及管理
Cureus. 2024 Aug 24;16(8):e67685. doi: 10.7759/cureus.67685. eCollection 2024 Aug.
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Systematic review and meta-analysis of the accuracy of lung ultrasound and chest radiography in diagnosing community acquired pneumonia in children.
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4
Lung Ultrasound Efficacy in Monitoring Post-SARS-CoV-2 Pneumonia and Inflammatory Biomarkers in Pediatric Patients.肺部超声在监测 SARS-CoV-2 后肺炎和儿科患者炎症生物标志物中的效果。
Medicina (Kaunas). 2024 Aug 11;60(8):1296. doi: 10.3390/medicina60081296.
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