摘要
目的探讨肺部超声(LUS)对儿童社区获得性肺炎(CAP)的诊断价值及其与胸部X线(CXR)、电子计算机断层扫描(CT)的影像学差异。方法选择2014年5月至2016年8月在成都市妇女儿童中心医院初诊为CAP的住院患者,在48h内进行LUS、胸部CT和CXR检查,根据实变、间质改变和胸膜线异常、胸腔积液、支气管征等影像学特征,以CT作为"金标准",评估LUS诊断CAP的敏感度、特异度、阳性预测值及阴性预测值,并与CXR比较。结果 180例患者纳入本研究,其中105例(58.33%)因临床需要经CT检查并诊断为CAP。LUS检测到胸膜线异常并出现B-线或发现肺实变时诊断CAP的敏感度、特异度、阳性预测值和阴性预测值分别为96.19%(101/105)、100.00%(75/75)、100.00%(101/101)和94.94%(75/79);CXR为92.38%(97/105)、100.00%(75/75)、100.00%(97/97)和90.36%(75/83),LUS敏感度高于CXR,但差异无统计学意义(χ~2=1.414,P=0.234)。LUS与CT诊断一致性较好(Kappa=0.955,P<0.01)。结论 LUS是诊断CAP的可靠工具,其敏感度、特异度、阳性预测值和阴性预测值与CT接近。
Objective To investigate the diagnostic value of lung ultrasound(LUS)in children with community acquired pneumonia(CAP),and to compare the imaging differences among LUS,chest X-ray(CXR),and computed tomography(CT).Methods From May 2014 to August 2016,the patients who were diagnosed with CAP in the department of respiratory of Chengdu Women′s and Children′s Central Hospital were examined by LUS,CT and CXR within 48 hours,according to consolidation,interstitial changes,pleural line,pleural effusion and bronchial signs,taking CT as the“gold standard”,evaluated the sensitivity,specificity,positive predictive value and negative predictive value of LUS for CAP diagnosis,and compared with CXR.Results A total of 180 patients were collected,105 cases(58.33%)were diagnosed with CAP due to CT examination.The sensitivity,specific,positive predictive value and negative predictive value of LUS were respectively 96.19%(101/105),100.00%(75/75),100.00%(101/101)and 94.94%(75/79);which of CXR were respectively 92.38%(97/105),100.00%(75/75),100.00%(97/97)and 70.36%(75/83),the sensitivity of LUS was higher than that of CXR,but there was no statistically significant difference(χ2=1.414,P=0.234).LUS had good diagnostic consistency with CT(Kappa=0.955,P<0.01).Conclusion LUS is a reliable tool for diagnosis with CAP,the sensitivity,specificity,positive predictive value and negative predictive value are close to CT.
作者
鲁佾
肖贞良
金梅
鲁正荣
赖华
樊映红
王莉
夏万敏
LU Yi;XIAO Zhenliang;JIN Mei;LU Zhengrong;LAI Hua;FAN Yinghong;WANG Li;XIA Wanmin(Graduate School of Clinical Medicine,Southwest Medical University,Luzhou,Sichuan 646000,China;Chengdu Women′s and Children′s Central Hospital Affiliated to Chongqing Medical University,Chengdu,Sichuan 610019,China)
出处
《重庆医学》
CAS
2018年第31期3994-3997,共4页
Chongqing medicine
基金
四川省成都市卫生局重大基金课题项目(2013004)
