关键词: 重症肺炎, 新生儿, 呼吸衰竭, 肺超声评分, 白细胞介素-17, 预测价值

Abstract: Objective To explore and analysis the application values of lung ultrasound scoring (LUS) combined with serological indicators detection in newborns with severe pneumonia. Methods From February 2019 to January 2023, 84 cases of neonates with severe pneumonia diagnosed and treated in Neonatal Intensive Care Unit (NICU) of a certain hospital were selected as the study subjects. All the neonates were given lung ultrasound evaluation and serum interleukin-17(IL-17) detection, and the occurrence of respiratory failure was recorded and the predictive value analysis of indices above was carried out. Results There were 24 cases diagnosed as respiratory failure(named after Respiratory failure group) in the 84 cases that accounted for 28.6%, with the others named after non Respiratory failure group. There were no significant differences in birth weight, age, length, gestational age, gender, delivery mode compared between Respiratory failure group and non Respiratory failure group (P>0.05). The lung ultrasonic scores of Respiratory failure group were significantly higher than that of non Respiratory failure group (P<0.05), and the serum IL-17 content of Respiratory failure group was significantly higher than that of non Respiratory failure group (P<0.05). In 84 children, the sensitivity of lung ultrasound score detection to predict respiratory failure of severe pneumonia newborns 78.4%, specificity of 5.4%, serum IL-17 content detection predicted the sensitivity of respiratory failure of severe pneumonia newborns 81.4%, specificity of 82.6%, combined index detection predicted the sensitivity of severe pneumonia newborns 85.7%, specificity of 82.6%. Receiver operating characteristic curve(ROC) curve analysis showed that the maximum area under the curve of pulmonary ultrasound score, serum IL-17 content and combined indices detected to predict respiratory failure in neonates with severe pneumonia were 0.782, 0.814 and 0.887, which suggested certain predictive accuracy. Conclusion The incidence of respiratory failure in neonates with severe pneumonia was relatively high, which could lead to the increase of pulmonary ultrasound score and the increase of serum IL-17 release. The application of pulmonary ultrasound score combined with serological indices in neonates with severe pneumonia could effectively predict the occurrence of respiratory failure.

Key words: severe pneumonia, newborns, respiratory failure, lung ultrasound score, interleukin-17, predictive value