摘要目的：研究新生儿感染性肺炎（infectious pneumonia，IPN）的超声影像学特点及肺脏超声对IPN的诊断价值。方法以2012年9月1日至2013年5月30日在北京军区总医院附属八一儿童医院新生儿重症监护中心住院，经病史、临床表现和胸部X线检查确诊为IPN的32例患儿为IPN组，以同期40例非肺脏疾病患儿为对照组。2组患儿均进行肺脏超声检查。观察正常及异常的肺脏超声表现，并对2组异常超声表现的出现情况（阳性率）进行比较。采用Fisher确切概率法进行统计学分析。结果正常肺组织呈低回声，胸膜线与A-线均呈清晰、光滑、规则的强回声，两者等间距平行排列、由近及远回声逐渐减弱，无或仅有少数几条B-线。IPN患儿的肺脏超声表现主要包括肺实变伴动态支气管充气征（100%，32/32）、A-线消失（100%，32/32）、间质综合征（100%，32/32）、胸膜线异常（91%，29/32）、肺滑消失（78%，25/32）、动态支气管充气征（66%，21/32）、肺搏动（38%，12/32）和胸腔积液（9%，3/32）。上述异常超声表现在对照组中均未见，2组比较，差异有统计学意义（Fisher确切概率法，P值均<0.001）。结论 IPN最主要的超声表现为边缘不规则的大面积肺实变伴支气管充气征、A-线消失和间质综合征，其次为胸膜线异常、实时超声下可见肺搏动和动态支气管充气征等，少数患儿可有胸腔积液。肺脏超声对IPN具有重要诊断价值。

abstractsObjective To evaluate the value of lung ultrasound in diagnosing infectious pneumonia (IPN) of newborns. Methods Seventy-two infants hospitalized from September 1, 2012 to May 30, 2013, in Bayi Children's Hospital, General Hospital of Beijing Military Command were divided into two groups. The study group consisted of 32 newborn infants diagnosed as IPN by medical history, clinical manifestations and chest X-ray, while the control group consisted of 40 neonates without any lung diseases. In a quiet state, the infants were placed in supine, side or prone position for lung ultrasound examination. The lung field was divided into three areas by the anterior and posterior axillary line. The regions of the bilateral lung were scanned by the probe which was vertical with the ribs. Fisher's exact was performed for stastical analysis. Results The most important ultrasound imaging findings of IPN included lung consolidation of varying size and shape with irregular and serrated margins (100%, 32/32), dynamic air bronchograms (100%, 32/32), A-line disappearance (100%, 32/32) and interstitial syndrome (100%, 32/32). Other common ultrasound signs included pleural line abnormalities (91%, 29/32), lung pulse (38%, 12/32) and dynamic air bronchograms (66%, 21/32) under real-time ultrasound. Pleural effusion was an infrequent sign that existed in 9%(3/32)of IPN patients. None of these abnormalities was observed in the control group. Conclusion Lung ultrasound is reliable for the diagnosis of IPN and can be routinely performed in neonatal intensive care units, and a large area of lung consolidation with irregular margins A-line disappearance, interstitial syndrome and pleural line abnormalities are the main image findings.