Noack G, Mortensson W, Robertson B, Nilsson R
Department of Paediatric Anaesthesiology, St. Göran's Hospital, Stockholm, Sweden.
Eur J Pediatr. 1993 Dec;152(12):1024-9. doi: 10.1007/BF01957230.
Sequential chest radiographs from 40 newborn infants requiring assisted ventilation for respiratory distress syndrome or other conditions were evaluated with a new scoring system aiming at identifying abnormal expansion patterns and interstitial infiltrates representing an early stage of bronchopulmonary dysplasia (BPD). Age at examination ranged from 3 to 23 days. Tracheal effluent samples obtained from the babies during the same period of observation were examined cytologically for evidence of regenerating airway epithelium with squamous metaplasia, indicating BPD. According to the radiological scoring system 24 babies (60%) developed BPD, first diagnosed at a median age of 9 days. By cytological criteria 20 babies (50%) developed BPD, first diagnosed at a median age of 10.5 days. The results from radiological and cytological diagnosis of BPD were concordant in 16 babies (P < 0.05 by chi-square test). Using oxygen dependency at the age of 28 days as evidence of established BPD, the radiological scoring system alone had a sensitivity of 93% and a specificity of 53%. The corresponding figures for cytological assessment alone were 73% and 58%, respectively. By combining radiological and cytological findings, values for sensitivity and specificity were 67% and 68%, respectively.
对40例因呼吸窘迫综合征或其他病症需要辅助通气的新生儿的系列胸部X光片，采用一种新的评分系统进行评估，该系统旨在识别代表支气管肺发育不良（BPD）早期阶段的异常扩张模式和间质浸润。检查时的年龄范围为3至23天。在同一观察期内从婴儿获取的气管流出物样本进行细胞学检查，以寻找气道上皮再生伴鳞状化生的证据，提示BPD。根据放射学评分系统，24例婴儿（60%）发生了BPD，首次诊断的中位年龄为9天。按照细胞学标准，20例婴儿（50%）发生了BPD，首次诊断的中位年龄为10.5天。16例婴儿的BPD放射学和细胞学诊断结果一致（卡方检验，P<0.05）。以28日龄时的氧依赖作为已确诊BPD的证据，单独使用放射学评分系统时，敏感性为93%，特异性为53%。单独细胞学评估的相应数字分别为73%和58%。通过结合放射学和细胞学结果，敏感性和特异性值分别为67%和68%。
