超声B线征与肺水肿严重程度的相关性
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摘要
目的探讨肺部超声B线征与肺水肿严重程度的相关性。方法将20只兔随机分为对照组(Non)5只、实验组15只,实验组再按油酸剂量不同分为轻度(Mil)、中度(Mod)、重度(Sev)3个亚组,每组5只。干预前沿锁骨中线及腋前线行经胸双侧肺部超声检查,记录有无B线征并存储超声动态图(3～5s)。对照组给予注射生理盐水10ml/kg。实验组给予注射不同剂量油酸,10min后再注射10ml/kg的生理盐水。生理盐水注射后均计时50min,即行经胸双侧肺部超声检查并记录存图。检查结束即处死兔取出左肺测量湿/干肺比值。结果随着油酸剂量增加,湿/干肺比值明显增加,其中Sev组相比Non、Mil组的湿/干肺比值较高(P<0.05),经胸肺部超声B线评分Mod、Sev组与Non组以及Mod、Sev组与Mil组相比也明显增加(P<0.05);不同油酸剂量与湿/干肺比值、B线评分均呈正相关(r值分别为0.574、0.954,P<0.05);湿/干肺比值与B线评分也呈正相关(r=0.690,P<0.01)。结论肺部超声B线征可反映肺水肿的严重程度,可用于半定量评估。
Objective To investigate the correlation between B line in lung ultrasound and severity of pulmonary edema.Methods The 20 rabbits were randomly divided into the control group(Non)(5)and the experimental group(15).The experimental group was randomly divided into 3 subgroups of mild(Mil),moderate(Mod)and severe(Sev)according to the different dosage of oleic acid,with 5 rabbits in each group.Before the intervention,ultrasound examination was performed on both sides of the chest along the midclavicular line and anterior-axillary line to record the presence of B line signs and to store ultrasonic dynamic images(3-5 s).The control group was given 10 ml/kg of saline injection,and the experimental group was given different doses of oleic acid,and then the same amount of saline was injected after 10 mins.50 mins after the injection of saline,the bilateral transthoracic lung ultrasound was performed and the ultrasonic images were saved.After ultrasound examination,the rabbit was executed.The left lung was taken out and the wet/dry lung ratio was measured.Results With the increase of oleic acid dose,the wet/dry lung ratio increased significantly between the severe oleate dosage group,and non-oleic acid dosage,and mild acid dosage group(P<0.05).There were also significantly increased in B line score of transthoracic lung ultrasound between non-oleic acid dosage group and moderate oleate dosage group,and severe oleate dosage group,also between the mild acid dosage group and moderate oleic acid dosage groups,and severe oleate dosage group(P<0.05).Different oleic acid dosage was positively correlated with wet/dry lung ratio(r=0.574,P<0.05)and B line score(r=0.954,P<0.01).Wet/dry lung ratio was positively correlated with the transthoracic lung ultrasonographic B line score(r=0.690,P<0.01).Conclusions B line in the ultrasonography can reflect the severity of pulmonary edema,so it can be used for semi-quantitative evaluation.
Objective To investigate the correlation between B line in lung ultrasound and severity of pulmonary edema.Methods The 20 rabbits were randomly divided into the control group(Non)(5)and the experimental group(15).The experimental group was randomly divided into 3 subgroups of mild(Mil),moderate(Mod)and severe(Sev)according to the different dosage of oleic acid,with 5 rabbits in each group.Before the intervention,ultrasound examination was performed on both sides of the chest along the midclavicular line and anterior-axillary line to record the presence of B line signs and to store ultrasonic dynamic images(3-5 s).The control group was given 10 ml/kg of saline injection,and the experimental group was given different doses of oleic acid,and then the same amount of saline was injected after 10 mins.50 mins after the injection of saline,the bilateral transthoracic lung ultrasound was performed and the ultrasonic images were saved.After ultrasound examination,the rabbit was executed.The left lung was taken out and the wet/dry lung ratio was measured.Results With the increase of oleic acid dose,the wet/dry lung ratio increased significantly between the severe oleate dosage group,and non-oleic acid dosage,and mild acid dosage group(P<0.05).There were also significantly increased in B line score of transthoracic lung ultrasound between non-oleic acid dosage group and moderate oleate dosage group,and severe oleate dosage group,also between the mild acid dosage group and moderate oleic acid dosage groups,and severe oleate dosage group(P<0.05).Different oleic acid dosage was positively correlated with wet/dry lung ratio(r=0.574,P<0.05)and B line score(r=0.954,P<0.01).Wet/dry lung ratio was positively correlated with the transthoracic lung ultrasonographic B line score(r=0.690,P<0.01).Conclusions B line in the ultrasonography can reflect the severity of pulmonary edema,so it can be used for semi-quantitative evaluation.
引文
[1]吕国荣,杨舒萍.肺部急重症超声[M].北京:北京大学医学出版社,2018:73-76.
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[4]PICANO E,PELLIKKA P A.Ultrasound of extravascular lung water:a new standard for pulmonary congestion[J].Eur Heart J,2016,37(27):2097-2104.
[5]李虹,李一丹,吕秀章,等.肺超声联合超声心动图评价左心衰患者的临床研究[J].中国超声医学杂志,2016,32(8):696-699.
[2]LI H,LI Y D,ZHU W W,et al.A simplified ultrasound comet tail grading scoring to assess pulmonary congestion in patients with heart failure[J].Biomed Res Int,2018,2018:8474839.
[3]TIERNEY D M,BOLAND L L,OVERGAARD J D,et al.Pulmonary ultrasound scoring system for intubated critically ill patients and its association with clinical metrics and mortality:Aprospective cohort study[J].J Clin Ultrasound,2018,46(1):14-22.
[4]PICANO E,PELLIKKA P A.Ultrasound of extravascular lung water:a new standard for pulmonary congestion[J].Eur Heart J,2016,37(27):2097-2104.
[5]李虹,李一丹,吕秀章,等.肺超声联合超声心动图评价左心衰患者的临床研究[J].中国超声医学杂志,2016,32(8):696-699.