The Application Of Ultrasonography Score In Neonatal Respiratory Distress Syndrome

Objective: To investigate the diagnostic value of lung ultrasonography score for evaluation of the state of neonatal respiratory distress syndrome(NRDS).Methods: Collected 103 cases newborns in the first day of life with RDS diagnosed by clinical and X-ray in Neonatal intensive care unit(NICU) of Hunan Children Hospital from October 2014 to December2015. All childrens were performed pulmonary ultrasound score. The rank correlation was used to analyze the relationship between ultrasonography score, the grade of abdominal ultrasound and the grade of X-ray. The linear regression was used to analyze the relationship between ultrasonography score and Oxygenation Index(OI),blood gas score, neonatal respiratory distress score, neonatal critical illness score.According to the diagnostic standard of respiratory distress scores,these children were divided into three groups including mild group, moderate group and severe group.According to the diagnostic standard of Neonatalcritical illness score(NCIS), children were divided into the other three groups including non-critical group, critical group, extremely critical group. Comparing the difference of ultrasound score among these groups.ROC curve was used to predict the packet truncation values of NRDS.The paired t examination was used to analyze the differences of blood gas score, neonatal respiratory distress score and ultrasonography score of the 39 cases newborns before and after using pulmonary surfactant.Results: There was a significant correlation between the ultrasonography score and the chest radiographs(r=-0.867, P<0.001).The grade of transabdominal lung ultrasound was positively correlated with the grade of X-ray(r=0.742,P<0.001). Ultrasonography score was significant differences in X-ray grade(P<0.001). Ultrasonography score was positively correlated with OI(r=0.828, P<0.001).Ultrasonography score was negatively correlated with blood gas score(r=-0.853, P<0.001).Ultrasonography score was negatively correlated with neonatal respiratory distress score(r=-0.882, P<0.001), There were significant differences in the ultrasonography score among the groups(P<0.001). In mild group and moderate group, the cut-off point was 27.5 points, AUC was 0.951, sensitivity was 86.7%, specificity was 95.3%. In the moderate group and the severe group,the cut-off point was 12.5 points,the AUC was 0.960,the sensitivity was 90.7%, the specificity was93.3%.Ultrasonography score was positively correlated with NCIS(r=0.875, P<0.001). There were statistically significant differences between groups of ultrasound score(P<0.001). The cut-off point was 27.5 points between the non-critical group and critical group, AUC was 0.907, the sensitivity was 83.7%, the specificity was 87.8%. The cut-off point was13.5 points between the critical group and extremely critical group, the AUC was 0.951, sensitivity was 92.7%, specificity was 89.5%. Before and after using PS, there were statistical significance in the differences of ultrasound score, blood gas score and respiratory distress score(P<0.001).Conclusion: Ultrasound score is closely related with the severity of disease. the higher the ultrasound score, the even less serious of NRDS,and vice versa.