经胸肺超声彗尾征诊断心源性呼吸困难

目的 探讨床旁经胸肺超声彗尾征诊断急性心源性呼吸困难的准确性。 方法 选择因急性呼吸困难入院的患者58例,于药物治疗前行床旁经胸肺超声检查。将患者分为心源性呼吸困难与肺源性呼吸困难,比较经胸肺超声检查结果,判断经胸肺超声彗尾征诊断心源性呼吸困难的敏感度、特异度及准确率。 结果 经胸肺超声彗尾征诊断急性心源性呼吸困难的敏感度为93.75%(30/32, 95%CI 77.78%~98.91%),特异度为88.46%(23/26, 95%CI 68.72%~96.97%),阳性预测值为90.90%(30/33, 95%CI 74.53%~97.62%),阴性预测值为92.00%(23/25,95%CI 72.50%~98.60%),诊断准确率为91.38%(53/58)。 结论 根据经胸肺超声彗尾征可以较准确地诊断急性心源性呼吸困难。

Transthoracic lung ultrasound displaying comet-tail sign in diagnosis of cardiogenic dyspnea

Objective To evaluate the diagnostic accuracy of bed side transthoracic lung ultrasound comet-tail sign in differentiating heart failure (HF)-related acute dyspnea from pulmonary-related acute dyspnea. Methods Fifty-eight patients with acute dyspnea who underwent transthoracic lung ultrasound before pharmacotherapy were enrolled. The patients were divided into HF-related acute dyspnea group and pulmonary-related acute dyspnea group. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy of lung ultrasound in identifying the HF-related acute dyspnea were assessed. Results Ultrasound comet-tail sign had a sensitivity of 93.75% (30/32, 95%CI 77.78%-98.91%), a specificity of 88.46% (23/26, 95%CI 68.72%-96.97%), PPV of 90.90% (30/33, 95%CI 74.53%-97.62%) and NPV of 92.00% (23/25, 95%CI 72.50%-98.60%) for the diagnosing HF-related acute dyspnea, and the accuracy was 91.38% (53/58). Conclusion Transthoracic ultrasound comet-tail sign has high diagnostic accuracy in differentiating acute HF-related from pulmonary-related acute dyspnea.