Respiratory Medicine and Research最新文献_第5页

First steps for telemonitoring mechanical cough assistance in people with neuromuscular diseases: The Tele-INEX study 神经肌肉疾病患者远程监测机械咳嗽辅助的第一步：Tele-INEX研究

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-10-03 DOI: 10.1016/j.resmer.2025.101213

M Lebret , D Zerillo , A Kerfourn , M Mahot , R Abouly , E Fresnel , JC Borel

引用次数: 0

The predicted value of maximal inspiratory pressure, maximal expiratory pressure, and sniff nasal inspiratory pressure for southeast asian adults 东南亚成人最大吸气压力、最大呼气压力和嗅鼻吸气压力的预测值

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-30 DOI: 10.1016/j.resmer.2025.101212

Ngoc-Minh Nguyen , Hanh Thi-Bich Tran , Thi-Quynh-Nhu Do , Nicolas Audag , Giuseppe Liistro , Philippe Fait , Gregory Reychler

Background

Accurate assessment of respiratory muscle strength is crucial for diagnosing and managing respiratory diseases. However, existing reference values may not be generalizable across diverse populations. This study aimed to establish predicted values for maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and sniff nasal inspiratory pressure (SNIP) in Southeast Asian adults.

Methods

MIP, MEP, and SNIP were measured in 301 healthy Vietnamese adults. Two-way ANOVA and post-hoc tests were used to examine differences in these measures among age groups and between genders. Stepwise multiple linear regression was used to develop predictive equations for MIP, MEP, and SNIP, with potential predictors including age, gender, body mass index, and lung function. The lower limit of the normal range (LLN) was determined using the fifth percentile of the negative residuals.

Results

MIP, MEP, and SNIP were higher in males than in females. MIP and MEP declined with age, while SNIP remained relatively stable. Predictive equations were established: MIP = 95.2 – 32.1 x gender (male = 0, female = 1) – 0.41 x age + 1.2 x BMI (adjusted R²: 41 %, LLN = predicted MIP – 34), MEP = 135.1 – 46.75 x gender (male = 0, female = 1) - 0.6 x age + 1.34 x BMI (adjusted R²: 41.8 %, LLN = predicted MEP – 50), SNIP = 63.8 – 18.16 x gender (male = 0, female = 1) (adjusted R²: 14.8 %, LLN = predicted SNIP – 30).

Conclusions

This study provides ethnic-specific predictive equations for MIP, MEP, and SNIP, which may serve as a preliminary step toward developing reference values for the Southeast Asian region.

背景：准确评估呼吸肌力量对诊断和治疗呼吸系统疾病至关重要。然而，现有的参考值可能无法在不同的人群中推广。本研究旨在建立东南亚成年人最大吸气压力（MIP）、最大呼气压力（MEP）和嗅鼻吸气压力（SNIP）的预测值。方法测定301例越南健康成人的smip、MEP和SNIP。采用双向方差分析和事后检验来检验这些措施在年龄组和性别之间的差异。采用逐步多元线性回归建立MIP、MEP和SNIP的预测方程，潜在的预测因子包括年龄、性别、体重指数和肺功能。正常范围的下限（LLN）是用负残差的第5个百分位数确定的。结果男性smip、MEP、SNIP均高于女性。MIP和MEP随年龄增长而下降，而SNIP保持相对稳定。建立了预测方程:MIP = 95.2 - 32.1 x性别(男= 0,女= 1)- 0.41 x + 1.2岁BMI (R2调整:41%,LLN =预测MIP - 34),欧洲议会议员= 135.1 - 46.75 x性别(男= 0,女= 1)- 0.6 x + 1.34岁BMI (R2调整:41.8%,LLN =预测MEP - 50),剪断= 63.8 - 18.16 x性别(男= 0,女= 1)(R2调整:14.8%,LLN =预测剪断- 30)。结论本研究提供了种族特异性的MIP、MEP和SNIP预测方程，为东南亚地区开发参考值奠定了基础。

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引用次数: 0

When to test for myositis antibodies in usual interstitial pneumonia on chest CT? 在常规间质性肺炎的胸部CT上什么时候检测肌炎抗体？

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-26 DOI: 10.1016/j.resmer.2025.101211

Eliott Guillois , Daniel Bertin , Jules Milesi , Paul Habert , Mathieu Di Bisceglie , Xavier Heim , Benjamin Coiffard , Romain Naud , Ana Nieves , Ngoc Anh Thu Nguyen , Martine Reynaud-Gaubert , Nathalie Bardin , Julien Bermudez

Introduction

Usual interstitial pneumonia (UIP) is a key pattern of interstitial lung disease (ILD), most commonly linked to idiopathic pulmonary fibrosis (IPF). Identifying underlying autoimmune conditions such as myositis is clinically relevant, yet guidelines provide limited recommendations regarding myositis antibody (MSA) screening.

Methods

We retrospectively analyzed patients with UIP who underwent systematic MSA screening at our center. Clinical and serological characteristics were compared between MSA-positive (MSA+) and MSA-negative (MSA-) groups. Logistic regression was used to identify predictive factors.

Results

Among 134 patients, 15 (11 %) were MSA+. Compared with MSA- patients, MSA+ cases were more likely to present with autoimmune disease (p = 0.03), ANA ≥ 1:320 (p < 0.001), and positive rheumatoid factor (p = 0.04). A four-parameter profile combining ANA < 1:320, absence of rheumatoid factor, no hypergammaglobulinemia, and no Raynaud’s phenomenon strongly predicted MSA negativity with excellent specificity (100 %), modest sensitivity (35 %), and good overall discriminative ability (AUC = 0.82).

Discussion

In patients with UIP, a simple four-parameter profile (ANA < 1:320, absence of rheumatoid factor, absence of hypergammaglobulinemia, and absence of Raynaud’s phenomenon) strongly predicts negative MSA status. These findings support a more targeted approach to MSA screening, potentially improving diagnostic accuracy, guiding treatment decisions, and reducing unnecessary testing in UIP.

常见性间质性肺炎（UIP）是间质性肺病（ILD）的一种关键类型，最常与特发性肺纤维化（IPF）相关。识别潜在的自身免疫性疾病如肌炎具有临床相关性，但指南对肌炎抗体（MSA）筛查的建议有限。方法回顾性分析在本中心接受系统MSA筛查的UIP患者。比较MSA阳性（MSA+）组和MSA阴性（MSA-）组的临床和血清学特征。采用Logistic回归分析确定预测因素。结果134例患者中MSA+ 15例（11%）。与MSA-患者相比，MSA+患者更容易出现自身免疫性疾病（p = 0.03）， ANA≥1:20 20 (p < 0.001)，类风湿因子阳性（p = 0.04）。ANA < 1:20 20，无类风湿因子，无高γ球蛋白血症，无雷诺现象的四参数谱能预测MSA阴性，具有良好的特异性（100%），适度的敏感性（35%）和良好的总体判别能力（AUC = 0.82）。在UIP患者中，简单的四参数谱（ANA < 1:320，无类风湿因子，无高γ球蛋白血症，无雷诺现象）强有力地预测了MSA的阴性状态。这些发现支持一种更有针对性的MSA筛查方法，可能提高诊断准确性，指导治疗决策，并减少UIP中不必要的检测。

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引用次数: 0

Acute hemodynamic response to inhaled treprostinil in pulmonary hypertension associated with interstitial lung disease: a case highlighting unresolved questions 肺高血压合并间质性肺疾病患者吸入曲前列替尼的急性血流动力学反应：一个突出未解决问题的病例

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-25 DOI: 10.1016/j.resmer.2025.101210

Marianne Riou , Matthieu Canuet , Sandrine Hirschi , Ségolène Turquier , David Montani

引用次数: 0

MUC5B polymorphism and post COVID-19 lung abnormalities on chest CT-scan MUC5B多态性与胸部ct扫描新冠肺炎后肺部异常

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-17 DOI: 10.1016/j.resmer.2025.101207

Celestie Yaacoub , Coralie Tardivon , Jean Dib , Spyridon Prountzos , Joe Yazbeck , Elvira-Markela Antonogiannaki , Ibrahima Ba , Christina Kontopoulou , Pinelopi Kazakou , Lykourgos Kolilekas , Anastasia Antoniadou , Bruno Crestani , Spyros A. Papiris , Effrosyni D. Manali , Quentin Philippot , Antoine Khalil , Cedric Laouenan , Raphael Borie , Marie-Pierre Debray , on behalf of the French COVID cohort study group

引用次数: 0

Understanding participation challenges in lung cancer screening program: Findings from the DEP’KP80 trial in France 了解参与肺癌筛查项目的挑战：来自法国DEP 'KP80试验的发现

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-17 DOI: 10.1016/j.resmer.2025.101208

Sébastien Couraud , Emmanuel Grolleau , Bernard Milleron , Valérie Petigny , Olivier Leleu

Background

Lung cancer is the leading cause of cancer-related mortality worldwide. Low-dose computed tomography (LDCT) screening can significantly reduce mortality among high-risk populations. However, participation rates in lung cancer screening programs are often suboptimal due to various barriers.

Method

The DEP’KP80 trial is a multicentric prospective study conducted in the French territory of Somme, assessing the feasibility of lung cancer screening using LDCT. Participants aged 55–74 with a smoking history of over 30 pack-years were recruited between 2016 and 2020. A questionnaire was administered to all participants to evaluate motivations and barriers to participation.

Results

The trial enrolled 1369 participants, with 30.4 % responding to the questionnaire. Of the responders, 65 % were male, and the mean age was 61.9 years. Key motivations for participation included health concerns related to smoking (68.7 %) and healthcare professional advice (16.5 %). Main barriers were perceived lack of invitation (37.5 %) and logistical issues (21.9 %). Notably, 63 % of responders reported that participation led to smoking cessation. In addition, the most common source of information about the program was healthcare professionals (85 %).

Conclusion

Our study highlights the crucial role of healthcare professionals in promoting lung cancer screening and identifies significant barriers to participation. Addressing these barriers through targeted interventions could enhance screening uptake and improve lung cancer outcomes.

背景肺癌是全球癌症相关死亡的主要原因。低剂量计算机断层扫描（LDCT）筛查可显著降低高危人群的死亡率。然而，由于各种障碍，肺癌筛查项目的参与率往往不是最佳的。DEP’kp80试验是一项在法国索姆省开展的多中心前瞻性研究，旨在评估LDCT筛查肺癌的可行性。参与者年龄在55-74岁之间，吸烟史超过30包年，于2016年至2020年间招募。对所有参与者进行了问卷调查，以评估参与的动机和障碍。结果共纳入1369名受试者，30.4 %的受试者回答了问卷调查。在应答者中，65% %为男性，平均年龄为61.9岁。参与的主要动机包括与吸烟有关的健康问题（68.7% %）和保健专业咨询（16.5% %）。主要障碍是缺乏邀请（37.5% %）和后勤问题（21.9% %）。值得注意的是，63% %的应答者报告说参与导致了戒烟。此外，关于该计划的最常见信息来源是医疗保健专业人员（85% %）。结论我们的研究强调了医疗保健专业人员在促进肺癌筛查方面的关键作用，并确定了参与筛查的重大障碍。通过有针对性的干预措施解决这些障碍，可以提高筛查的接受程度，改善肺癌的预后。

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引用次数: 0

Classification of systemic lupus erythematosus in patients with interstitial pneumonia with autoimmune features using two different sets of criteria 两套不同标准对具有自身免疫特征的间质性肺炎患者系统性红斑狼疮的分类

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-17 DOI: 10.1016/j.resmer.2025.101206

Gabriela Martinez-Zayas , David Karp , Traci N. Adams , Elena K. Joerns

Objective

Interstitial pneumonia with autoimmune features (IPAF) describes patients with interstitial lung disease and autoimmunity who do not meet classification criteria for a systemic autoimmune rheumatic disease, including systemic lupus erythematosus (SLE). We aimed to determine whether the criteria developed by the European Alliance of Association of Rheumatology and American College of Rheumatology (EULAR/ACR) would classify more patients with IPAF as SLE, than those developed by the Systemic Lupus International Collaborating Clinics (SLICC). Increasing the recognition of SLE among patients with IPAF may affect therapy.

Methods

This observational, retrospective, single-center cohort study included consecutive patients initially classified as having IPAF between December 2005-August 2019. We reviewed patients’ charts to assess whether more patients met SLE criteria by SLICC or EULAR/ACR methodology. Fisher’s exact test assessed the significance of the difference in the proportion of patients classified by the two criteria.

Results

We included 201 patients initially classified as IPAF. Twelve were identified as SLE by SLICC criteria and 23 by EULAR/ACR criteria. All but three patients with lymphopenia who met SLE criteria by SLICC also met it by EULAR/ACR. The difference in the proportion of IPAF patients meeting SLE criteria by the two methods was statistically significant (p < 0.001).

Conclusions

Patients with IPAF were classified as SLE more frequently using EULAR/ACR criteria than by SLICC criteria. The EULAR/ACR criteria may be superior for SLE classification in patients with ILD. Patients with IPAF and SLE features should undergo full work-up to evaluate for SLE classification as it may affect therapy.

目的：具有自身免疫性特征的间质性肺炎（IPAF）描述了不符合系统性自身免疫性风湿病（包括系统性红斑狼疮（SLE））分类标准的间质性肺疾病和自身免疫患者。我们的目的是确定由欧洲风湿病协会联盟和美国风湿病学会（EULAR/ACR）制定的标准是否会比由系统性狼疮国际合作诊所（SLICC）制定的标准将更多的IPAF患者分类为SLE。提高IPAF患者对SLE的认识可能会影响治疗。方法：这项观察性、回顾性、单中心队列研究纳入了2005年12月至2019年8月期间最初被分类为IPAF的连续患者。我们回顾了患者的图表，以评估是否有更多的患者符合SLICC或EULAR/ACR方法的SLE标准。Fisher的精确检验评估了按两种标准分类的患者比例差异的显著性。结果：我们纳入了201例初始分类为IPAF的患者。12例根据SLICC标准确诊为SLE， 23例根据EULAR/ACR标准确诊为SLE。除3例淋巴细胞减少患者外，所有通过SLICC达到SLE标准的患者也通过EULAR/ACR达到SLE标准。两种方法IPAF患者符合SLE标准的比例差异有统计学意义（p < 0.001）。结论：与SLICC标准相比，EULAR/ACR标准更频繁地将IPAF患者分类为SLE。对于ILD患者的SLE分类，EULAR/ACR标准可能更优。具有IPAF和SLE特征的患者应进行全面检查以评估SLE的分类，因为它可能影响治疗。

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引用次数: 0

Impact of the COVID-19 pandemic on lung cancer diagnosis, treatment, mortality, and survival in Belgium: A population-based study COVID-19大流行对比利时肺癌诊断、治疗、死亡率和生存率的影响：一项基于人群的研究

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-17 DOI: 10.1016/j.resmer.2025.101205

Hanne Peirelinck , Hanna M. Peacock , Geert Silversmit , Thierry Berghmans , Paul De Leyn , Ingel Demedts , Xavier Geets , Yolande Lievens , Harlinde De Schutter

Background

We evaluated the impact of COVID-19 on the care pathway and outcomes for patients diagnosed with lung cancer in 2020 in Belgium.

Methods

Lung cancer patients diagnosed in 2017–2020 were extracted from the nationwide Belgian Cancer Registry database. Characteristics and treatment of patients in 2020 were compared with 2017–2019 at semester level (January-June: S1; July-December: S2). 90-day post-operative mortality and relative survival (RS) at 1 and 3 years for 2020 were compared with the 2017–2019 trend.

Results

The study included 29,721 patients diagnosed with lung cancer in 2017–2020. Patients diagnosed in 2020 had a poorer WHO Performance status and more often distant metastases compared to the corresponding semester in 2017–2019. In 2020 S2, there was slightly less surgery performed in patients with early-stage (I-II) lung cancer in favour of radiotherapy (RT) (surgery:4.7 percent-points, RT +6.0 percent-points, p = 0.001). RT courses had a shorter median duration (S1:4 days; S2:4 days) and lower median number of fractions (S1:5; S2:5). The unadjusted 90-day post-operative mortality increased, but this increase was no longer significant when adjusting for case-mix (unadjusted: Odds ratio (OR) =1.85 [1.05–3.24]; adjusted: (OR 1.78 [0.99–3.21]). There was no significant change in RS at 1 and 3 years, with or without case-mix adjustment (unadjusted: 1-year excess hazard ratio (EHR)=1.06 [1.00–1.12], 3-year EHR=1.05 [1.00–1.11]; adjusted: 1-year EHR=1.02 [0.96–1.08], 3-year EHR=1.02 [0.96–1.07]).

Conclusion

Lung cancer patients in Belgium experienced only minor changes in their care pathway during the COVID-19 pandemic. The changes in stage distribution and the increase in 90-day postoperative mortality warrant monitoring of long-term outcomes.

背景：我们评估了2019冠状病毒病对比利时2020年肺癌患者护理途径和结局的影响。方法：从比利时全国癌症登记数据库中提取2017-2020年诊断的肺癌患者。以学期为单位（1 - 6月：S1； 7- 12月：S2）比较2020年与2017-2019年患者的特征及治疗。将2020年术后90天死亡率和1年和3年相对生存率（RS）与2017-2019年趋势进行比较。结果：该研究纳入了2017-2020年诊断为肺癌的29,721例患者。与2017-2019年相应学期相比，2020年诊断出的患者的世卫组织绩效状况较差，远处转移的情况也更多。2020年，早期（I-II）肺癌患者的手术治疗略少于放疗（RT）（手术：4.7个百分点，RT +6.0个百分点，p = 0.001）。RT疗程的中位数持续时间较短（S1:4天；S2:4天），分数中位数较低（S1:5; S2:5）。未调整的术后90天死亡率增加，但在调整病例组合后，这种增加不再显著(未调整：优势比(OR) =1.85 [1.05-3.24]；调整后：（OR 1.78[0.99-3.21]）。无论是否进行病例组合调整，1年和3年的RS均无显著变化(未经调整：1年超额风险比=1.06[1.00-1.12]，3年超额风险比=1.05 [1.00-1.11]；调整后：1年EHR=1.02[0.96-1.08]， 3年EHR=1.02[0.96-1.07])。结论：在2019冠状病毒病大流行期间，比利时肺癌患者的护理途径仅发生了微小变化。分期分布的变化和术后90天死亡率的增加需要对长期预后进行监测。

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引用次数: 0

Pulmonary arterial stiffness as the main correlate of effective arterial elastance in pre- and post-capillary pulmonary hypertension 肺动脉僵硬度是毛细管高压前后有效动脉弹性的主要相关因素。

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-09-04 DOI: 10.1016/j.resmer.2025.101204

Denis Chemla , Antoine Beurnier , Christian Gerges , Xavier Jaïs , Athenaïs Boucly , Laurent Savale , Olivier Sitbon , Marc Humbert , David Montani , Philippe Hervé

Background

A simplified estimate of pulmonary effective arterial elastance (Ea_sPAP), defined as systolic pulmonary artery (PA) pressure divided by stroke volume (SV), is increasingly used to quantify total PA load and its coupling with right ventricle in pulmonary hypertension (PH), with elevated Ea_sPAP associated with worse prognosis. Although arterial elastance is thought to depend more on pulmonary vascular resistance (PVR) than on stiffness, the value of this simplified, clinically derived estimate remains unclear.

Methods

This retrospective invasive study included 236 adults diagnosed with idiopathic pulmonary arterial hypertension (n = 118) or post-capillary PH (n = 118), matched for age, sex, and mean PA pressure (mPAP). Total PA stiffness was defined as PA pulse pressure/SV.

Results

In the overall population (63 % women, median age 70 years, mPAP 38 mmHg), Ea_sPAP correlated most strongly with stiffness (Spearman ρ=0.95). The same was observed in both groups, with regression lines showing similar slopes and intercepts. These correlations were explained by the superimposable linear relationships between systolic and pulse pressures, together with the shared SV in the formulas. Ea_sPAP was less strongly associated with PVR (ρ=0.83) (P < 0.0001), with differing slopes and intercepts between groups. Similar results were observed when downstream pressure was included in elastance calculation, and in the youngest age tertile.

Conclusions

In PH patients, Ea_sPAP most closely correlated with the PA pulse pressure/SV ratio, the standard clinical estimate of total PA stiffness. This overlap among clinical indices of PA load warrants recognition, suggesting right ventricular responses may be mainly driven by pulsatile load, with potential therapeutic implications.

背景：肺有效动脉弹性（EasPAP）的简化估计，定义为收缩期肺动脉（PA）压力除以卒中体积（SV），越来越多地用于量化肺动脉高压（PH）患者的总PA负荷及其与右心室的耦合，EasPAP升高与预后不良相关。尽管动脉弹性被认为更多地依赖于肺血管阻力（PVR）而不是刚度，但这种简化的临床推导估计的价值仍不清楚。方法：这项回顾性侵入性研究包括236名被诊断为特发性肺动脉高压（n = 118）或毛细血管后PH （n = 118）的成年人，年龄、性别和平均肺动脉压（mPAP）相匹配。PA总刚度定义为PA脉冲压力/SV。结果：在总体人群中（63%为女性，中位年龄70岁，mPAP 38 mmHg）， EasPAP与僵硬度相关性最强（Spearman ρ=0.95）。在两组中观察到相同的结果，回归线显示相似的斜率和截距。这些相关性可以用收缩压和脉压之间可叠加的线性关系以及公式中共享的SV来解释。EasPAP与PVR的相关性较弱（ρ=0.83）（P < 0.0001），组间斜率和截距不同。同样的结果也被观察到，当下游压力被包括在弹性计算中，在最年轻的年龄的瓷砖。结论：在PH患者中，EasPAP与PA脉压/SV比（PA总僵硬度的标准临床估计）最密切相关。PA负荷的临床指标之间的这种重叠值得确认，表明右心室反应可能主要由搏动负荷驱动，具有潜在的治疗意义。

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引用次数: 0

Editorial – "Lung ultrasound and community-acquired pneumonia: from complementary tool to clinical game-changer" 社论-《肺部超声和社区获得性肺炎：从辅助工具到临床游戏规则改变者》

IF 1.8 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2025-08-30 DOI: 10.1016/j.resmer.2025.101203

Luigi Vetrugno , Damiano D’Ardes , Cristian Deana , Daniele Guerino Biasucci , Andrea Boccatonda

Community-acquired pneumonia (CAP) remains a major global health concern, traditionally diagnosed through chest X-ray (CXR). However, lung ultrasound (LUS) is increasingly emerging as a transformative tool in both diagnosis and management. Evidence from recent meta-analyses reveals that LUS outperforms CXR in sensitivity and rivals it in specificity, with pooled diagnostic accuracies exceeding 90 %. Unlike CXR, LUS is radiation-free, cost-effective, and ideal for bedside use, making it particularly valuable in emergency departments, intensive care units, pediatric and geriatric populations, and resource-limited settings. In children, LUS spares radiation exposure, while in elderly patients, contrast-enhanced ultrasound improves diagnostic specificity. Beyond diagnosis, LUS enables dynamic monitoring, prognostic scoring (e.g., LUS score, CPIS-PLUS), and supports treatment decisions such as ventilator weaning and antibiotic stewardship. Recent applications during the COVID-19 pandemic have demonstrated its effectiveness in triage and outcome prediction. Despite challenges such as operator dependency and reduced penetration for deep lesions, technological advances—particularly artificial intelligence and handheld devices—are mitigating these limitations. Deep learning models now interpret LUS images with high accuracy, enhancing reproducibility and accessibility for general practitioners. In low- and middle-income countries, LUS serves as a crucial diagnostic bridge, improving access and reducing reliance on costly imaging modalities. As training programs and standardized scoring systems evolve, LUS is becoming a frontline tool rather than a supplementary option. Its integration into clinical practice promises to reshape pneumonia care through rapid, accurate, and scalable diagnostics. In light of these advancements, LUS is not just complementary to radiography—it is redefining the diagnostic landscape of pneumonia.

社区获得性肺炎（CAP）仍然是一个主要的全球卫生问题，传统上是通过胸部x射线（CXR）诊断的。然而，肺超声（LUS）越来越多地成为诊断和管理的变革性工具。来自最近荟萃分析的证据显示，LUS在敏感性上优于CXR，在特异性上优于CXR，合并诊断准确率超过90% %。与CXR不同，LUS无辐射，具有成本效益，是床边使用的理想选择，因此在急诊科、重症监护病房、儿科和老年人群以及资源有限的环境中特别有价值。在儿童中，LUS可以避免辐射暴露，而在老年患者中，造影增强超声可以提高诊断特异性。除了诊断之外，LUS还支持动态监测、预后评分（例如，LUS评分、CPIS-PLUS），并支持治疗决策，如呼吸机脱机和抗生素管理。最近在COVID-19大流行期间的应用已经证明了它在分类和结果预测方面的有效性。尽管存在操作员依赖性和深度病变穿透减少等挑战，但技术进步（尤其是人工智能和手持设备）正在缓解这些限制。深度学习模型现在以高精度解释LUS图像，增强了全科医生的再现性和可访问性。在低收入和中等收入国家，LUS是一个重要的诊断桥梁，改善了获取途径并减少了对昂贵成像方式的依赖。随着培训项目和标准化评分系统的发展，LUS正在成为一线工具，而不是补充选项。将其整合到临床实践中，有望通过快速、准确和可扩展的诊断重塑肺炎护理。鉴于这些进步，LUS不仅仅是对x线摄影的补充，它正在重新定义肺炎的诊断前景。

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引用次数: 0