摘要
目的 探讨肺超声评分(LUS)对油酸致山羊急性肺损伤(ALI)的诊断价值。方法 将16只山羊随机分为轻伤组和重伤组,每组各8只,通过耳缘静脉分别注射不同剂量油酸(轻伤组0.05 ml/kg,重伤组0.10 ml/kg),建立相应ALI模型。以山羊双侧胸壁第5肋为界分为左上、左下、右上及右下4个肺区,于致伤前和致伤后1 h、3 h、6 h动态观察两组山羊全肺及各肺区超声表现,比较两组LUS的差异;绘制受试者工作特征(ROC)曲线分析致伤后1 h、3 h、6 h全肺及各肺区LUS预测山羊ALI严重程度的诊断价值。通过血气分析和炎症因子检测分别获得各时间点动脉血气指标[氧分压(PaO_(2))、氧饱和度(SaO_(2))、氧合指数(PaO_(2)/FiO_(2))]和肿瘤坏死因子-α(TNF-α),比较两组上述指标的差异。然后处死山羊,观察肺大体损伤情况,取肺组织行病理组织学检查并进行病理损伤评分,计算肺湿干比,分析全肺及各肺区LUS与肺湿干比、病理损伤评分的相关性。结果 轻伤组1只山羊于致伤后5 h死亡,余山羊均成功建立油酸诱导ALI模型。(1)各ALI模型致伤后全肺LUS随着时间增加呈逐渐上升趋势,重伤组致伤后1 h、3 h、6 h全肺LUS均高于轻伤组,差异均有统计学意义(均P<0.05)。两组致伤后1 h、3 h、6 h右下肺LUS比较差异均有统计学意义(均P<0.05),其余肺区LUS比较差异均无统计学意义;重伤组致伤后6 h左下肺LUS高于左上肺,致伤后3 h、6 h右下肺LUS均高于右上肺,差异均有统计学意义(均P<0.05);轻伤组致伤后同一时间点各肺区LUS比较差异均无统计学意义。(2)ROC曲线分析显示,致伤后各时间点全肺LUS预测山羊ALI严重程度的曲线下面积(AUC)均>0.8;各时间点右下肺LUS预测山羊ALI严重程度的AUC均>0.9,其中致伤后1 h右下肺LUS的预测效能最高(AUC=0.938)。(3)重伤组致伤后3 h、6 h PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)均低于轻伤组,差异均有统计学意义(均P<0.05)。轻、重�
Objective To investigate the diagnostic value of lung ultrasound score(LUS)in oleic acid-induced acute lung injury(ALI)in goats.Methods Totally 16 goats were randomly divided into mild injury group and severe injury group,with 8 goats in each group.The ALI models were induced by injecting varying doses of oleic acid(0.05 ml/kg for the mild injury group and 0.10 ml/kg for the severe injury group)via the ear vein.The goat’s bilateral chest wall was divided into four lung regions with the fifth rib as the boundary:left upper,left lower,right upper,and right lower.Lung ultrasound was performed on the entire lung and each lung region before the injury and 1 h,3 h,and 6 h after the injury,the difference of LUS between two groups was compared.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of LUS in the entire lung and each lung area in predicting the severity of goat ALI at 1 h,3 h,and 6 h after injury.Arterial blood gas indicators[partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2)),and oxygenation index(PaO_(2)/FiO_(2))]and tumor necrosis factor-α(TNF-α)were obtained by blood gas analysis and inflammatory factor detection at each time point.The differences of above indicators between the two groups were compared.Subsequently,the goats were sacrificed,and the entire lung injury was observed.Lung tissue samples were taken for pathological histological examination and pathological injury score determination,the lung wet-dry ratio was calculated.The correlation between LUS of the entire lung and each lung region and the lung wet-dry ratio,pathological injury score were analyzed.Results One goat in the mild injury group died 5 h after the injury,while the remaining goats were successfully established the oleic acid-induced goat ALI model.①The LUS of the entire lung after injury exhibited a progressive increase with the time extend,and the LUS of the entire lung in severe injury group was higher than that of the mild injury group at 1 h,3 h,and 6 h after the injury,the
作者
张滢滢
韩冬
陈潇
阳欢
李冠桦
曾琳
汪远华
方靖琴
王建民
李陶
ZHANG Yingying;HAN Dong;CHEN Xiao;YANG Huan;LI Guanhua;ZENG Lin;WANG Yuanhua;FANG Jingqin;WANG Jianmin;LI Tao(Department of Ultrasound Diagnosis,Daping Hospital,Army Military Medical University,Chongqing 400042,China)
出处
《临床超声医学杂志》
CSCD
2024年第1期1-8,共8页
Journal of Clinical Ultrasound in Medicine
基金
国家重点研发计划项目(2023YFC3011801)
省部级课题(ALJ18J001)
重庆市技术创新与应用示范社会民生类一般项目(cstc2018jscx-msybX0018)。
关键词
肺超声评分
油酸
急性肺损伤
诊断效能
山羊
Lung ultrasound score
Oleic acid
Acute lung injury
Diagnostic efficacy
Goats
