摘要
目的探讨肺部超声联合肺表面活性蛋白A(SP-A)对早产儿呼吸窘迫综合征(RDS)病情严重程度的预测价值。方法选取108例诊断为新生儿呼吸窘迫综合征(NRDS)的早产儿作为NRDS组,依据患儿病情严重程度分为轻度组(69例)和重度组(39例),另选取无NRDS的早产儿50例作为对照组。记录各组患儿肺部超声评分及血清SP-A水平,绘制受试者工作特征(ROC)曲线,计算二者对早产儿RDS病情严重程度的预测价值。结果NRDS组患儿肺部超声评分及血清SP-A水平均高于对照组(P<0.05)。NRDS患儿肺部超声评分及血清SP-A水平随着NRDS病情分级的增加而明显升高,且组间两两比较,差异有统计学意义(P<0.05)。重度组患儿肺部超声评分及血清SP-A水平均高于轻度组(P<0.05)。肺部超声评分及血清SP-A水平预测早产儿RDS病情严重程度的曲线下面积(AUC)分别为0.856(95%CI:0.783~0.930)和0.889(95%CI:0.813~0.966),二者联合检测的AUC为0.937(95%CI:0.879~0.996),高于二者单独检测,二者联合检测的灵敏度(94.90%)和特异度(88.40%)也高于单独检测。结论NRDS患儿肺部超声评分及血清SP-A水平均异常升高,且随着NRDS病情分级的增加而升高,二者联合检测可以进一步提高对早产儿RDS病情严重程度预测的敏感度和特异度。
Objective To explore the predictive value of pulmonary ultrasound combined with surfactant protein A(SP-A)for the severity of respiratory distress syndrome(RDS)in premature infants.Methods One hundred and eight premature infants diagnosed with neonatal respiratory distress syndrome(NRDS)were selected as NRDS group,they were divided into mild group(69 cases)and severe group(39 cases)based on the severity of their condition.Additionally,50 premature infants without NRDS were selected as the control group.The pulmonary ultrasound scores and serum SP-A levels of each group of children were recorded,the receiver operating characteristic(ROC)curve were drew,their predictive value for the severity of RDS in premature infants were calculated.Results The pulmonary ultrasound scores and serum SP-A level in the NRDS group were higher than those in the control group(P<0.05).The pulmonary ultrasound score and serum SP-A level in children with NRDS increased with the increase of NRDS disease grading,and the differences between groups were statistically significant(P<0.05).The pulmonary ultrasound scores and serum SP-A level in the severe group were higher than those in the mild group(P<0.05).The area under the curve(AUC)for predicting the severity of RDS in premature infants using pulmonary ultrasound scores and serum SP-A levels were 0.856(95%CI:0.783-0.930)and 0.889(95%CI:0.813-0.966),respectively.The AUC for the combined detection of the two was 0.937(95%CI:0.879-0.996),which was higher than that of the two alone.The sensitivity(94.90%)and specificity(88.40%)of the combined detection were also higher than those of the two alone.Conclusion The pulmonary ultrasound score and serum SP-A level in children with NRDS are abnormally elevated,and they increase with the increase of NRDS disease grading,their combined detection can further improve the sensitivity and specificity of predicting the severity of RDS in premature infants.
作者
孔岩
唐成和
丁远
李冉
KONG Yan;TANG Chenghe;DING Yuan;LI Ran(Department of Ultrasound,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China;Department of Neonatology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China)
出处
《河南医学研究》
2026年第3期403-406,共4页
Henan Medical Research
基金
2023年度河南省医学科技攻关计划联合共建项目(LHGJ20230518)。
关键词
早产儿
呼吸窘迫综合征
肺部超声
肺表面活性蛋白A
病情严重程度
预测价值
premature infants
respiratory distress syndrome
pulmonary ultrasound
surfactant protein A
severity of illness
predictive value
