床旁肺超声彗星尾征在急性心力衰竭诊断中的价值

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Abstract Objective To explore the application value of bedside ultrasound lung comets (ULCs) in the patients with acute heart failure (AHF). Methods Forty cases of patients with AHF admitted to the Department of Emergency of Chongqing General Hospital (the Third Branch) from May 2016 to May 2017 were collected. Within 24 hours of the diagnosis, all patients were examined by the experienced examiners respectively by bedside lung ultrasound and chest CT. The correlation between pulmonary ultrasonography scores and chest CT scoresis was determined, as well as the correlation between the number of ULCs and echocardiographic parameters [left atrial diameter (LA), left ventricular end-diastolic diameter (LVEDD), ejection fraction (EF)], and the specificity and sensitivity of patients with AHF were identified by ULCs. Results Pulmonary ultrasonic scores for patients were (16.43±4.31) scores, and the chest CT scores were (12.11±5.32) scores, there was a significant linear correlation between the two scores (r = 0.561, P ＜ 0.01). The number of ULCs was positively correlated with LA and LVEDD (r = 0.331, P ＜ 0.01; r = 0.325, P ＜ 0.01), and negatively correlated with EF (r = -0.378, P ＜ 0.01). The area under the ROC curve for ULCs was 0.933 (95%CI: 0.895, 0.980). When the number of ULCs was more than 5, the sensitivity to diagnose AHF was 90.2% (37/41) and the specificity was 66.7% (6/9); when the number of ULCs was more than 8, the sensitivity to diagnose AHF was reduced to 68.3% (28/41) and the specificity was 88.9% (8/9); when the number of ULCs was greater than 20, the sensitivity of diagnosis of AHF was reduced to 51.2% (21/41) and specificity reached 100.0% (9/9). Conclusion Ultrasound lung detection of ULCs is a good method for evaluating and determining AHF. It has high sensitivity and specificity, and has broad application prospect in AHF assessment.

Key words： Ultrasound lung comets Bedside ultrasound Acute heart failure

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	ZENG Jun1 WANG Hongqun2 LIU Xi1 WAN Zhonggeng1 LIU Jian1 LIU Yan1

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ZENG Jun1 WANG Hongqun2 LIU Xi1 WAN Zhonggeng1 LIU Jian1 LIU Yan1. The value of bedside ultrasound lung comets in the diagnosis of acute heart failure[J]. 中国医药导报, 2019, 16(25): 83-86.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I25/83

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