探讨不同临床分型新型冠状病毒肺炎（COVID-19）的肺部超声声像图特点，为临床诊断与疗效评估提供参考。

回顾性分析2020年3月至7月首都医科大学附属北京地坛医院收治经临床确诊的COVID-19患者共39例，其中普通型13例、重型15例、危重型11例，均于入院时行床旁肺超声检查，观察入组患者肺部超声声像图特征。

胸膜线超声表现：胸膜线连续但不规则、不光滑或合并胸膜增厚者占23.08%（9/39）；胸膜线不连续，出现破损者占46.15%（18/39）；胸膜线模糊，出现严重破损者占30.77%（12/39）。B线：出现B线但≤ 3条者占2.56%（1/39）；B线增多，≥ 4条者占2.56%（1/39）；B线明显增多，融合呈"瀑布征"者占94.87%（37/39）。肺实变：未发生实变者占23.08%（9/39）；发生胸膜下小实变者占53.85%（21/39）；发生大片样实变伴其内支气管气相者占20.51%（9/39）。不同临床分型COVID-19患者肺超声声像图特点：表现为胸膜线连续但不规则、不光滑或合并胸膜增厚和未发生实变的患者中普通型患者占比最多，分别占全部临床分型的66.7%（6/9）和77.8%（7/9）；而胸膜线不连续、出现破损和发生胸膜下小实变的患者以重型患者占比最多，分别为50%（9/18）和50.0%（11/22）；表现为胸膜线模糊、出现严重破损和发生大片样实变伴其内支气管气相以危重型患者占比最多，分别为50%（6/12）和62.5%（5/8）。其中不同临床分型中超声指标未发生实变的患者比例差异有统计学意义（P = 0.003）。

不同临床分型的COVID-19患者肺超声声像图特征不同，可为临床诊断与疗效评估提供参考。

To investigate the lung ultrasound characteristics in different clinical classifications of coronavirus disease 2019 (COVID-19), and to provide references for clinical diagnosis and efficacy evaluation.

Thirty-nine patients with clinically diagnosed COVID-19 from March to July 2020 in Beijing Ditan Hospital, Capital Medical University were analyzed, retrospectively, including 13 patients with general type, 15 patients with severe type and 11 patients with critical type. All patients underwent lung ultrasound examination, and the features of lung ultrasound images were observed.

Ultrasound findings of pleural line: continuous but irregular and unsmooth pleural lines, or with thickened pleural were observed in 23.08% (9/39) patients; discontinuous and damaged pleural lines were detected in 46.15% (18/39) patients; blurred and serious damaged pleural lines occurred in 30.77% (12/39) patients. B lines: 2.56% (1/39) patients detected B lines (≤ 3); 2.56% (1/39) patients with B increased lines (≥ 4); significantly increased B lines which fused into "waterfall sign" were observed in 94.87% (37/39) patients. Consolidation: 23.08% (9/39) patients were without consolidation; small subpleural consolidation occurred in 53.85% (21/39) patients; large-scale consolidation with air bronchogram sign occurred in 20.51% (9/39) patients. Lung ultrasound features in COVID-19 patients with different clinical classifications: among all the patients with continuous but irregular and unsmooth pleural lines or combined with pleural thickening and no consolidation, the general type accounted for the largest proportion, accounting for 66.7% (6/9) and 77.8% (7/9) of all clinical classifications. Discontinuous pleural line, rupture, and small subpleural consolidation mostly occurred in severe type patients, accounting for 50% (9/18) and 50.0% (11/22), respectively. Blurred and serious damaged pleural lines and large-scale consolidation with air bronchogram sign mostly presented in critical patients, accounting for 50% (6/12) and 62.5% (5/8), respectively. The absence of consolidation was significantly different among different clinical subtypes (P = 0.003).

Different clinical classifications of COVID-19 patients have different features in lung ultrasound, which could provide reference for clinical diagnosis and efficacy evaluation.