首页|急性期新型冠状病毒感染的肺部床旁超声特征及其与临床指标相关性的研究

急性期新型冠状病毒感染的肺部床旁超声特征及其与临床指标相关性的研究

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目的 分析急性期新型冠状病毒感染(COVID-19)的肺部床旁超声特征,探讨肺部床旁超声半定量评分(LUS)与临床指标的相关性。方法 选取川北医学院附属医院收治入院的急性期COVID-19 患者 30 例,采用BLUE-PLUS方案对患者行肺部顺序扫查,行床旁超声半定量评分;并收集患者的二氧化碳分压、阴离子间隙、PH值、标准碳酸氢根、氧分压、淋巴细胞百分比(LYM%)、淋巴细胞绝对值(LYM#)、临床分型、住院时间等临床指标,比较急性期COVID-19 不同临床分型患者的LUS,分析LUS与临床指标的相关性。绘制受试者工作特征(ROC)曲线,分析LUS用于普通型与(危)重型分型的效能。结果 30 例急性期COVID-19 患者中,双侧均至少有一个肺点受累者 29 例(96。7%),单侧至少有一个肺点受累者 1 例(3。3%),15 例患者出现至少一个肺点的肺实变大小>1 cm。行左、右肺相同肺点得分比较,左、右肺总得分之间比较,差异有统计学意义(P<0。05);行不同临床分型患者各肺点得分之间比较:普通型与危重型患者的左肺总得分、右肺总得分及全肺总得分比较,差异均有统计学意义(P<0。05)。全肺总得分诊断普通型与(危)重型分型的曲线下面积(AUC)为0。870。左肺总得分、右肺总得分、全肺总得分与LYM%、LYM#、阴离子间隙无相关性(P>0。05),与临床分型、住院时间呈正相关,与标准碳酸氢根呈负相关(P<0。05);左肺总得分、全肺总得分与PH值、氧分压呈负相关,与二氧化碳分压呈正相关(P<0。05),右肺总得分与PH值、二氧化碳分压、氧分压无相关性(P>0。05)。结论 急性期COVID-19 不同临床分型患者的床旁超声特征具有差异性,LUS与PH值、二氧化碳分压、标准碳酸氢根、氧分压、临床分型、住院时间存在相关性,危重型患者LUS得分较高;肺部床旁超声有望用于急性期COVID-19 患者的临床分型及病情评估。
Study on the features of lung point-of-care ultrasound in acute Covid-19 and its correlation with clini-cal indicators
Objective To investigate the correlation between lung Point-of-Care ultrasound score and clinical indicators by analyzing the features of Point-of-Care ultrasound in acute COVID-19.Methods 30 COVID-19 patients admitted to the Affili-ated Hospital of North Sichuan Medical College were selected,lung Point-of-Care ultrasound sequential scan was conducted in pa-tients with the BLUE-PLUS regimen and the lung Point-of-Care ultrasound semi-quantitative scoring was performed.The clinical indicators of partial pressure of carbon dioxide,anion gap,PH value,standard bicarbonate,oxygen partial pressure,oxygen satu-ration,the lymphocyte percentage(LYM% ),the lymphocytic absolute value(LYM#),the clinical typing,hospital stay,etc were collected.The lung Point-of-Care ultrasound score of acute COVID-19 patients in different clinical typing was compared and the features of Point-of-Care ultrasound in acute COVID-19 were analyzed.The ROC curve was constructed to analyze the effec-tiveness of lung Point-of-Care ultrasound score for the typing of normal type and(critical)severe type.Results In 30 cases of COVID-19 patients during the acute period,there were 29 patients with at least one lung point involvement on both sides(96.7% ),1 case with at least one lung point involvement on one side(3.3% )and 15 cases showed Lung consolidation>1cm at least one lung point.Comparison of the same lung point between the left and right lung was performed and there was statistical-ly significant difference in the total scores between the left and right lung(P<0.05).Comparison of total scores of different lung points in patients with different clinical types showed there was statistically significant difference in the total scores of left lung,the total scores of right lung,the total scores of whole lung between normal type and critical type(P<0.05).The area under the curve(AUC)for the diagnosis of normal and(critical)severe types based on the total lung scores is 0.870.The total scores of the left lung,right lung,and whole lung were not correlated with LYM% ,LYM#,and anion gap(P>0.05)were positively cor-related with clinical typing and hospital stay,and negatively correlated with standard bicarbonate(P<0.05).The total scores of the left lung and whole lung were negatively correlated with PH value,oxygen partial pressure,and oxygen saturation,but posi-tively correlated with partial pressure of carbon dioxide(P<0.05).The total scores of the right lung was not correlated with PH value,partial pressure of carbon dioxide,oxygen partial pressure,and oxygen saturation(P>0.05).Conclusion There were differences in Point-of-Care ultrasound features among patients with different clinical types of acute COVID-19,Lung Point-of-Care ultrasound semi-quantitative scoring is correlated with pH value,partial pressure of carbon dioxide,standard bicarbonate,ox-ygen partial pressure,oxygen saturation,clinical typing and hospital stay.The patients of critical type have higher scores,lung Point-of-Care ultrasound is expected to be used for clinical typing and condition evaluation of acute COVID-19 patients.

Lung ultrasoundScoreCovid-19B line

刘颜州、岳文胜、杨航、张曦月

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川北医学院附属医院//川北医学院附属医院院士工作站//川北医学院附属医院超声研究室//医学影像四川省重点实验室//超声医学工程南充市重点实验室 四川南充 637000

肺部超声 评分 新型冠状病毒感染 COVID-19 B线

四川省科技厅应用基础研究项目

19YYJC0378

2024

现代医院
广东省医院协会

现代医院

影响因子:1.332
ISSN:1671-332X
年,卷(期):2024.24(1)
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