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目的:探讨肺部超声在新生儿呼吸窘迫综合征（neonatal respiratory distress syndrome，RDS）诊断及疗效评估中的应用价值。方法:本研究为回顾性研究，纳入2017年4月至2019年4月汕头大学医学院第一附属医院新生儿重症监护室根据临床表现及胸部X线确诊为RDS的早产儿为RDS组，按1∶1的比例纳入同期无心肺疾病早产儿为对照组，分析RDS患儿肺部超声图像特征，应用SPSS 19.0统计软件对比各级RDS肺部超声图像，分析各级RDS肺部超声图像与胸部X线的相关性，通过肺部超声和胸部X线评估肺表面活性物质的治疗效果。结果:RDS组和对照组分别纳入69例早产儿。RDS患儿肺部超声胸膜线异常、A线异常、出现B线、肺泡间质综合征（alveolar interstitial syndrome，AIS）阳性率均为100%，肺实变及白肺样改变阳性率分别为71.0%和49.3%，胸膜线异常、肺实变及白肺样改变3种征象同时存在诊断RDS的敏感度40.5%、特异度100%、阳性预测值100%、阴性预测值62.7%，胸膜线异常、肺实变、AIS 3种征象同时存在诊断RDS的敏感度71.0%、特异度100%、阳性预测值100%、阴性预测值77.5%。胸部X线RDS分级越高，肺部超声出现肺实变肺分区数目越多（n r=0.836，n P<0.05），评分越高（n r=0.868， n P<0.05）。超声评分10分预测Ⅱ级RDS的敏感度80.0%、特异度94.4%，超声评分15分预测Ⅲ级RDS的敏感度87.5%、特异度75.0%，超声评分25分预测Ⅳ级RDS的敏感度100%、特异度68.0%。肺部超声与胸部X线评估RDS疗效具有较高的一致性（n κ=0.896，n P<0.05）。n 结论:肺部超声诊断RDS具有较高的特异度并可反映病情严重程度，评估疗效与胸部X线具有较高的一致性，可作为RDS诊断与疗效评估的检查手段。“,”Objective:To study the value of lung ultrasound (LUS) in the diagnosis and evaluation of therapeutic effects of neonatal respiratory distress syndrome (RDS).Method:From April 2017 to April 2019, premature infants with RDS diagnosed based on clinical manifestations and chest X-ray (CXR) in the neonatal intensive care unit (NICU) of our hospital were retrospectively analyzed. Premature infants without cardiopulmonary disease during the same period were included as the control group. The LUS characteristics of RDS infants were analyzed and the LUS images of different degrees of RDS were compared. The correlation between LUS and CXR was analyzed and the therapeutic effects of pulmonary surfactant (PS) were evaluated using LUS and CXR.Result:Sixty-nine premature infants were included in the RDS group and the control group, respectively. The positive rates of abnormal pleural line, abnormal A line, B line appearance and alveolar interstitial syndrome (AIS) in infants with RDS were 100%. 71.0% RDS infants had pulmonary consolidation and 49.3% had “white lung”. If pleural line abnormality, lung consolidation and white lung presented at the same time, the sensitivity, specificity, positive predictive value (PPV)and negative predictive values (NPV) of RDS were 40.5%, 100%, 100% and 62.7%, respectively. If pleural line abnormality, pulmonary consolidation and AIS presented at the same time, the sensitivity, specificity, PPV and NPV of RDS were 71.0%, 100%, 100% and 77.5%, respectively. The higher the RDS grade, the more lung consolidations (n r=0.836, n P<0.05) and higher LUS score (n r=0.868, n P<0.05). To predict the severity of RDS, the sensitivity and specificity of LUS score 10 for grade Ⅱ RDS were 80.0% and 94.4%, LUS score 15 for grade Ⅲ RDS were 87.5% and 75.0%, LUS score 15 for grade Ⅳ RDS were 87.5% and 75.0%, LUS score 25 for grade Ⅳ RDS were 100% and 68.0%. LUS and CXR had good consistency evaluating the therapeutic effects of PS (n κ=0.896, n P<0.05).n Conclusion:LUS has a high specificity for diagnosis of RDS and can reflect the severity of the disease, LUS also has good consistency with CXR in evaluating the therapeutic effects of PS. LUS can be used as an effective tool for the diagnosis and evaluation of therapeutic effects of RDS.