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[1]万磊,杨灵杰,孟庆欣,等.超声诊断重症肺炎的临床价值[J].医学研究与战创伤救治(原医学研究生学报),2022,24(3):253-256.[doi:10.3969/j.issn.1672-271X.2022.03.006]
　WAN Lei,YANG Ling-jie,MENG Qing-xin,et al.Clinical value of lung ultrasound combined with laboratory indexes in evaluation of severe pneumonia[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(3):253-256.[doi:10.3969/j.issn.1672-271X.2022.03.006]
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超声诊断重症肺炎的临床价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年3期
页码:
253-256
栏目:
临床研究
出版日期:
2022-06-30

文章信息/Info

Title:
Clinical value of lung ultrasound combined with laboratory indexes in evaluation of severe pneumonia
作者:
万磊; 杨灵杰; 孟庆欣; 常志刚
作者单位：234000宿州，宿州市第一人民医院超声科（万磊），重症监护室（常志刚）；214400江阴，解放军63680部队医院特检科（杨灵杰）；210002南京，东部战区总医院（原南京军区南京总医院）超声诊断科（孟庆欣）
Author(s):
WAN Lei;  YANG Ling-jie;  MENG Qing-xin;  CHANG Zhi-gang
(1.Department of Ultrasound,2.Intensive Care Unit, Suzhou First People′s Hospital, Suzhou 234000,Anhui, China；3.Special Examination Department， 63680 Army Hospital, PLA, Jiangyin 214400, Jiangsu, China；4.Ultrasound Diagnosis Department,General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China)
关键词:
重症肺炎; 肺部超声; 降钙素原; C反应蛋白
Keywords:
severe pneumonia;  lung ultrasound;  procalcitonin;  C-reactive protein
分类号:
R563.1R445.1
DOI:
10.3969/j.issn.1672-271X.2022.03.006
文献标志码:
A
摘要:
目的探讨超声诊断重症肺炎的临床价值。方法选取2017年2月至2021年10月宿州市第一人民医院收治的98例重症肺炎患者（重症肺炎组），并选择同一时间段医院接收的98例普通肺炎患者（普通肺炎组）及98例健康志愿者（健康组）。对比3组肺部超声评分及诊断肺炎的相关实验室指标降钙素原（PCT）、C反应蛋白（CRP）水平，分析超声评分对重症肺炎的诊断价值。结果重症肺炎组患者肺部超声评分、PCT及CRP水平高于普通肺炎组，普通肺炎组患者肺部超声评分、PCT及CRP水平高于健康组（P均＜0.05）。重症肺炎并发急性呼吸窘迫综合症（ARDS）发生率为24.49%，肺部超声评分达到（19.88±1.83）分，是诊断重症肺炎并发症ARDS的重要依据，且并发ARDS者各项监测指标均高于未未并发ARDS者（P<0.05）。对重症肺炎的诊断，肺部超声检测评分阳性率（91.84%）高于PCT（61.35%）、CRP（71.43%）实验室指标的检测（P<0.05）。 结论超声对重症肺炎的诊断具有重要价值，优于肺炎的相关实验室指标PCT、CRP水平，同时为诊断重症肺炎并发症ARDS提供新的途径，为指导治疗节省时间，值得临床推广。
Abstract:
ObjectiveTo explore the clinical value of ultrasound in the diagnosis of severe pneumonia.Methods98 patients with severe pneumonia treated in Suzhou First People’s Hospital from February 2017 to October 2021 were recorded as severe pneumonia group, and 98 patients with ordinary pneumonia and 98 healthy volunteers received in our hospital at the same time were recorded as ordinary pneumonia group and healthy group. The lung ultrasound score, PCT and CRP levels of the three groups were comparable, and the diagnostic value of ultrasound score in severe pneumonia was analyzed.ResultsThe lung ultrasound scores, PCT and CRP levels of the patients with severe pneumonia group were higher than those of the ordinary pneumonia group, and the lung ultrasound scores, PCT and CRP levels of the patients with ordinary pneumonia group were higher than those of the healthy group (all P＜0.05). The incidence of severe pneumonia complicated with acute respiratory distress syndrome (ARDS) was 24.49%. Pulmonary ultrasound score, PCT and CRP level were of great significance in the diagnosis of complicated ARDS. Pulmonary ultrasound score reached （19.88±1.83）score, which was an important basis for the diagnosis of severe pneumonia complicated ARDS, and the monitoring indexes of complications were higher than those in the non complicated group (P＜0.05). For the diagnosis of severe pneumonia, the positive rate of pulmonary ultrasound score (91.84%) was higher than that of PCT (61.35%) and CRP (71.43%) (P＜0.05).ConclusionUltrasound has an important value in the diagnosis of severe pneumonia, which is better than the level of PCT and CRP. At the same time, it provides a new way for the diagnosis of severe pneumonia complication ARDS, saves time for guiding clinical treatment, and is worth popularizing.

参考文献/References:

[1]Goh KJ, Choong MC, Cheong EH, et al. Rapid progression to acute respiratory distress syndrome: review of current understanding of critical illness from covid-19 infection [J]. Ann Acad Med Singap, 2020, 49(3):108-118.
[2]许永春,许毓灵,余涛,等.血清清蛋白及C反应蛋白对新型冠状病毒肺炎预后的评估价值[J].医学研究生学报,2021,34(3):278-281.
[3]Cheng ZB, Chen H. Higher incidence of acute respiratory distress syndrome in cardiac surgical patients with elevated serum procalcitonin concentration: a prospective cohort study [J]. Eur J Med Res, 2020, 25(1):11.
[4]Yang Q, Xie L, Zhang W, et al. Analysis of the clinical characteristics, drug treatments and prognoses of 136 patients with coronavirus disease 2019 [J]. J Clin Pharm Ther, 2020, 45(4):609-616.
[5]宋秀明. 专家诊治肺炎[M]. 上海: 上海科学技术文献出版社, 2012: 89-98.
[6]李虹, 李一丹, 朱维维, 等. 高频胸膜肺超声对呼吸困难患者肺部疾病的诊断价值:与CT对照研究[J]. 中华超声影像学杂志, 2016, 25(4):305-308.
[7]蔡玉龙,刘炯,夏国际,等.托珠单抗治疗高龄新型冠状病毒肺炎患者的临床疗效[J].东南国防医药,2021,23(1):75-77.
[8]ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition [J]. JAMA, 2012, 307(23):2526-2533.
[9]Matthay MA, Zemans RL, Zimmerman GA, et al. Acute respiratory distress syndrome [J]. Nat Rev Dis Primers, 2019, 5(1):18.
[10]Tomazini BM, Maia IS, Cavalcanti AB, et al. Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and covid-19: the codex randomized clinical trial [J]. JAMA, 2020, 324(13):1307-1316.
[11]郑翠霞,崔绘丽,吴栋云,等.新型冠状病毒肺炎恢复期血浆治疗对重型患者活动耐力的影响[J].东南国防医药,2020,22(5):487-491.
[12]Pan F, Yang L, Li Y, et al. Factors associated with death outcome in patients with severe coronavirus disease-19 (COVID-19): a case-control study [J]. Int J Med Sci, 2020, 17(9):1281-1292.
[13]吴彬, 刘小男, 闵苏, 等. 肺部超声评分在新型冠状病毒肺炎并发ARDS患者中的应用[J]. 重庆医科大学学报, 2020, 45(7):44-47.
[14]王海霞, 彭亚岚, 吕林. 血清降钙素原水平与重症肺炎伴ARDS发病的相关性及对病情严重程度的评估价值[J]. 海南医学, 2018, 29(10):1397-1400.
[15]Huang I, Pranata R, Lim MA, et al. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis [J]. Ther Adv Respir Dis, 2020, 14(6):54-61.

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备注/Memo

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更新日期/Last Update: 2022-06-21