无症状健康哮喘儿童的肺部超声表现
2022/07/19
摘要
背景：肺超声（LUS）已被证明是快速诊断小儿呼吸窘迫某些原因的有效工具。然而，关于LUS在儿童哮喘中的发现知之甚少。
目的：本研究的主要目的是描述明确诊断为哮喘的儿童队列中的LUS发现，不包括哮喘加重。
方法：符合条件的患者，年龄6至17岁，诊断为哮喘，在门诊期间接受LUS。LUS使用六区扫描协议进行。LUS伪影的存在由以下一个或多个定义：≥每个肋间间隙3条B线，肺实变和/或胸膜异常。图像由不了解患者临床特征的专业超声医生进行解释。
结果：共52例患者被纳入。52例患者中有10例（19.2%）出现LUS伪影：8例出现LUS伪影≥3条B型线，1例实变>1cm，7例胸膜下实变<1cm，1例胸膜线异常。60%的受试者在右前区和右外侧区可见伪影，所有受试者在一个肺区内仅局限于1-2个肋间间隙。未发现LUS伪影的存在与哮喘控制或严重程度之间存在相关性。
结论：据我们所知，这是首次在门诊儿童哮喘中发现LUS。哮喘儿童的LUS伪影可以在急性发作之外看到。当使用LUS对哮喘患儿进行急性评估时，需要考虑这些基线结果。
Lung Ultrasound Findings in Asymptomatic Healthy Children with Asthma
Noah Marzook, Francois Gagnon, Alexandre Deragon, David Zielinski, Adam J Shapiro, Larry C Lands, Alexander S Dubrovsky
Abstract
Background:：Lung ultrasound (LUS) has been shown to be an effective tool to rapidly diagnose certain causes of pediatric respiratory distress. However, very little is known about LUS findings in pediatric asthma.
Objectives：The primary objective of this study was to characterize LUS findings in a cohort of pediatric patients with a definitive diagnosis of asthma, outside of an asthma exacerbation.
Methods：Eligible patients, aged 6 to 17 years old and diagnosed with asthma, underwent LUS during an outpatient visit. LUS was conducted using a six-zone scanning protocol. Presence of a LUS artifact was defined by one or more of the following: ≥3 B-lines per intercostal space, pulmonary consolidation and/or pleural abnormality. Images were interpreted by an expert sonographer blinded to patient clinical characteristics.
Results：52 patients were included. 10/52 (19.2%) patients demonstrated the presence of LUS artifacts: 8 with ≥3 B-lines, 1 with consolidation >1cm and 7 with subpleural consolidations <1cm, 1 with a pleural line abnormality. Artifacts were seen in the right anterior and lateral zones in 60% of participants and were limited to 1-2 intercostal space(s) within one lung zone in all participants. No association was found between presence of LUS artifacts and asthma control or severity.
Conclusion：To our knowledge, this is the first report of LUS findings in outpatient pediatric asthma. LUS artifacts in asthmatic children can be seen outside of acute exacerbations. Such baseline findings need to be taken into consideration when using LUS for the acute evaluation of a pediatric patient with asthma.
背景：肺超声（LUS）已被证明是快速诊断小儿呼吸窘迫某些原因的有效工具。然而，关于LUS在儿童哮喘中的发现知之甚少。
目的：本研究的主要目的是描述明确诊断为哮喘的儿童队列中的LUS发现，不包括哮喘加重。
方法：符合条件的患者，年龄6至17岁，诊断为哮喘，在门诊期间接受LUS。LUS使用六区扫描协议进行。LUS伪影的存在由以下一个或多个定义：≥每个肋间间隙3条B线，肺实变和/或胸膜异常。图像由不了解患者临床特征的专业超声医生进行解释。
结果：共52例患者被纳入。52例患者中有10例（19.2%）出现LUS伪影：8例出现LUS伪影≥3条B型线，1例实变>1cm，7例胸膜下实变<1cm，1例胸膜线异常。60%的受试者在右前区和右外侧区可见伪影，所有受试者在一个肺区内仅局限于1-2个肋间间隙。未发现LUS伪影的存在与哮喘控制或严重程度之间存在相关性。
结论：据我们所知，这是首次在门诊儿童哮喘中发现LUS。哮喘儿童的LUS伪影可以在急性发作之外看到。当使用LUS对哮喘患儿进行急性评估时，需要考虑这些基线结果。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Pediatr Pulmonol. 2022 Jul 6. doi: 10.1002/ppul.26061.)
(Pediatr Pulmonol. 2022 Jul 6. doi: 10.1002/ppul.26061.)
Lung Ultrasound Findings in Asymptomatic Healthy Children with Asthma
Noah Marzook, Francois Gagnon, Alexandre Deragon, David Zielinski, Adam J Shapiro, Larry C Lands, Alexander S Dubrovsky
Abstract
Background:：Lung ultrasound (LUS) has been shown to be an effective tool to rapidly diagnose certain causes of pediatric respiratory distress. However, very little is known about LUS findings in pediatric asthma.
Objectives：The primary objective of this study was to characterize LUS findings in a cohort of pediatric patients with a definitive diagnosis of asthma, outside of an asthma exacerbation.
Methods：Eligible patients, aged 6 to 17 years old and diagnosed with asthma, underwent LUS during an outpatient visit. LUS was conducted using a six-zone scanning protocol. Presence of a LUS artifact was defined by one or more of the following: ≥3 B-lines per intercostal space, pulmonary consolidation and/or pleural abnormality. Images were interpreted by an expert sonographer blinded to patient clinical characteristics.
Results：52 patients were included. 10/52 (19.2%) patients demonstrated the presence of LUS artifacts: 8 with ≥3 B-lines, 1 with consolidation >1cm and 7 with subpleural consolidations <1cm, 1 with a pleural line abnormality. Artifacts were seen in the right anterior and lateral zones in 60% of participants and were limited to 1-2 intercostal space(s) within one lung zone in all participants. No association was found between presence of LUS artifacts and asthma control or severity.
Conclusion：To our knowledge, this is the first report of LUS findings in outpatient pediatric asthma. LUS artifacts in asthmatic children can be seen outside of acute exacerbations. Such baseline findings need to be taken into consideration when using LUS for the acute evaluation of a pediatric patient with asthma.
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