BACKGROUND The aim of this study was to investigate the feasibility of lung ultrasound in the diagnosis of neonatal respiratory distress syndrome (NRDS) in preterm infants. METHODS One hundred and nine preterm infants were prospectively recruited. Three ultrasound diagnostic criteria were developed to diagnose preterm infants with NRDS: (A) thickened or not smooth pleural line, part of the lung field shows diffuse 'B-line' sign or alveolar-interstitial syndrome (AIS); (B) thickened or not smooth pleural line, all lung fields show AIS, signifying the 'white lung' sign; (C) thickened or rough pleural line, 'white lung' sign and 'lung consolidation' sign can be observed in any lung field. RESULTS The sensitivity and negative predictive value of NRDS in preterm infants with diagnostic criteria A were 100%, but the specificity and positive predictive value were 67.95 and 55.36%, respectively. The specificity and positive predictive value of diagnostic criteria B and C were 100%, while the 95% CI of diagnostic criteria B was narrower than diagnostic criteria C. The sensitivity and negative predictive value of diagnostic criteria B were higher than that of diagnostic criteria C. Of the 31 NRDS cases, 15 cases had severe NRDS and the other 16 did not have severe NRDS. CONCLUSION Thickened or rough pleural line with white lung sign is an important characteristic for the diagnosis of NRDS by lung ultrasound. White lung sign combined with the lung consolidation sign had high diagnostic efficacy when distinguishing severe NRDS from not severe NRDS.

中文翻译：

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超声诊断早产儿呼吸窘迫综合征的可行性。

背景 本研究的目的是探讨肺部超声诊断早产儿新生儿呼吸窘迫综合征（NRDS）的可行性。方法前瞻性招募了 109 名早产儿。制定了诊断早产儿NRDS的三个超声诊断标准：（A）胸膜线增厚或不光滑，部分肺野呈弥漫性“B线”征或肺泡间质综合征（AIS）；(B) 胸膜线增厚或不光滑，全肺野显示AIS，提示“白肺”征；(C) 任何肺野均可观察到胸膜线增厚或粗糙、“白肺”征和“肺实变”征。结果 诊断标准 A 的早产儿 NRDS 的敏感性和阴性预测值均为 100%，但特异性和阳性预测值分别为67.95和55.36%。诊断标准B和C的特异性和阳性预测值均为100%，而诊断标准B的95% CI窄于诊断标准C。诊断标准B的敏感性和阴性预测值均高于诊断标准C . 31例NRDS中，15例为重症NRDS，16例无重症NRDS。结论 胸膜线增厚或粗糙伴白肺征是肺部超声诊断NRDS的重要特征。白肺征联合肺实变征对鉴别重度NRDS与非重度NRDS具有较高的诊断效能。诊断标准B和C的特异性和阳性预测值均为100%，而诊断标准B的95% CI窄于诊断标准C。诊断标准B的敏感性和阴性预测值均高于诊断标准C . 31例NRDS中，15例为重症NRDS，16例无重症NRDS。结论 胸膜线增厚或粗糙伴白肺征是肺部超声诊断NRDS的重要特征。白肺征联合肺实变征对鉴别重度NRDS与非重度NRDS具有较高的诊断效能。诊断标准B和C的特异性和阳性预测值均为100%，而诊断标准B的95% CI窄于诊断标准C。诊断标准B的敏感性和阴性预测值均高于诊断标准C . 31例NRDS中，15例为重症NRDS，16例无重症NRDS。结论 胸膜线增厚或粗糙伴白肺征是肺部超声诊断NRDS的重要特征。白肺征联合肺实变征对鉴别重度NRDS与非重度NRDS具有较高的诊断效能。诊断标准B的敏感性和阴性预测值均高于诊断标准C。31例NRDS中，15例为重度NRDS，16例无重度NRDS。结论 胸膜线增厚或粗糙伴白肺征是肺部超声诊断NRDS的重要特征。白肺征联合肺实变征对鉴别重度NRDS与非重度NRDS具有较高的诊断效能。诊断标准B的敏感性和阴性预测值均高于诊断标准C。31例NRDS中，15例为重度NRDS，16例无重度NRDS。结论 胸膜线增厚或粗糙伴白肺征是肺部超声诊断NRDS的重要特征。白肺征联合肺实变征对鉴别重度NRDS与非重度NRDS具有较高的诊断效能。