Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
Department of Surgery, Shiyan Maternal and Child Health Hospital, Shiyan, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e39590. doi: 10.1097/MD.0000000000039590.
This study aimed to evaluate the diagnostic value of ultrasound for community-acquired pneumonia (CAP) in children.
Clinical information of children diagnosed with CAP and a control group of healthy children was collected, and lung ultrasound detection was performed. The lung ultrasound score (LUS) was assessed, and venous blood samples were collected. Serum indexes, including white blood cell count, were analyzed using an automatic immunoassay analyzer, while serum procalcitonin (PCT) level was measured using an enzyme-linked immunosorbent assay. The pediatric critical illness score (PCIS) was also performed for all subjects.
White blood cell count, absolute neutrophil count, and respiratory index were significantly higher in the CAP group than those in the control group, while the oxygenation index was markedly lower. Ultrasound detection results showed that the CAP group exhibited significantly higher detection rates of pleural effusion, interstitial lung changes, lung consolidation, B-lines, air bronchogram signs, and reduced or absent lung sliding signs compared with the control group. In addition, the LUS and PCT levels were markedly higher in the CAP group, while the PCIS was notably lower. Further analysis exhibited that the LUS in the CAP group was significantly positively correlated with PCT levels and negatively correlated with PCIS. The receiver operating characteristic curve indicated that the area under the curve of LUS for diagnosing children with lung infection was 0.841.
LUS is closely related to serum PCT level and PCIS. Lung ultrasound detection demonstrates high sensitivity and specificity, indicating its valuable clinical diagnostic utility for CAP in children.
本研究旨在评估超声在儿童社区获得性肺炎(CAP)中的诊断价值。
收集了确诊为 CAP 的患儿和健康儿童对照组的临床资料,进行肺部超声检查,评估肺部超声评分(LUS),采集静脉血标本,采用自动免疫分析仪检测白细胞计数等血清指标,酶联免疫吸附法检测血清降钙素原(PCT)水平。对所有受试者进行小儿危重症评分(PCIS)。
CAP 组患儿白细胞计数、中性粒细胞绝对值和呼吸指数均明显高于对照组,而氧合指数明显降低。超声检测结果显示,CAP 组患儿胸腔积液、间质肺改变、肺实变、B 线、空气支气管征和肺滑动征缺失或减少的检出率明显高于对照组。此外,CAP 组的 LUS 和 PCT 水平明显升高,而 PCIS 明显降低。进一步分析表明,CAP 组 LUS 与 PCT 水平呈显著正相关,与 PCIS 呈显著负相关。受试者工作特征曲线表明,LUS 诊断儿童肺部感染的曲线下面积为 0.841。
LUS 与血清 PCT 水平和 PCIS 密切相关。肺部超声检测具有较高的敏感性和特异性,对儿童 CAP 具有重要的临床诊断价值。