肺超声诊断急性心力衰竭的准确性

Mohamed Yahia, M. Soliman, M. Fawzy, Hatem Sultan
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摘要

背景与目的虽然急性心力衰竭(AHF)是呼吸困难的常见原因,但其诊断仍然是一个挑战。肺超声是一种新兴的即时诊断工具,但其诊断AHF的性能仍在评估中。我们评估了肺部超声结合临床评估与胸片、超声心动图和n端前b型利钠肽(NT-proBNP)结合临床评估在急诊科诊断AHF的准确性和临床实用性。患者和方法共47例出现呼吸困难和提示AHF症状的患者通过NT-proBNP、超声心动图和胸片进行评估。肺超声检查弥漫性b线的存在。结果肺超声诊断AHF的敏感性为91.9%,特异性为100%,血浆NT-proBNP诊断AHF的敏感性为100%,特异性为60%。它也优于其他诊断AHF的方法,即胸片。肺超声与超声心动图结果有显著相关性(P=0.001)。结论在临床评价的基础上实施肺部超声检查,提高了急诊科诊断AHF的准确性。
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Diagnostic accuracy of lung ultrasound in acute heart failure
Background and objective Although acute heart failure (AHF) is a common cause of dyspnea, its diagnosis still represents a challenge. Lung ultrasound is an emerging point-of-care diagnostic tool, but its diagnostic performance for AHF is still under evaluation. We evaluated the accuracy and clinical usefulness of combining lung ultrasound with clinical assessment compared with the use of chest radiography, echocardiography, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in conjunction with clinical evaluation for diagnosing AHF in the emergency department. Patients and methods A total of 47 patients presenting with dyspnea and symptoms suggestive of AHF were evaluated by NT-proBNP, echocardiography, and chest radiography. Lung ultrasound was done to look for the presence of diffuse B-lines. Results Lung ultrasound showed a sensitivity of 91.9% and a specificity of 100% in diagnosing AHF comparable to plasma NT-proBNP, which had a sensitivity of 100% and a specificity of 60%. It was also superior to other methods of diagnosing AHF namely chest radiograph. Lung ultrasound showed a significant correlation with the echocardiography findings (P=0.001). Conclusion The implementation of lung ultrasound with the clinical evaluation improves accuracy of diagnosis of AHF in the emergency department.
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