急性呼吸窘迫综合征亚型与精准诊治  

Acute respiratory ditresss syndrome Subphenotypes for accurate diagnosis and treatment

作　　者：张红强 张冰[1] 梁璐[1] 瞿海龙[1] ZHANG Hongqiang;ZHANG Bing;LIANG Lu;QU Hailong(Emergency Department,Affiliated Hospital of Hebei University,Baoding Hebei 071000,China)

机构地区：[1]河北大学附属医院急诊医学科,河北保定071000

出　　处：《中国急救复苏与灾害医学杂志》2023年第9期1245-1247,1255,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家科技基础资源调查专项(编号:2017FY101200);保定市科技计划项目(编号:2141ZF302)。

摘　　要：急性呼吸窘迫综合征(ARDS)是由各种致病因素引起的,以急性低氧、顺应性降低、非心源性肺水肿为特点的临床综合征。尽管目前药物治疗、呼吸支持、干细胞应用取得很大进步,然而仍有很高的病死率。ARDS作为一种综合征,其诊断标准相对宽泛,不同病因、不同机体条件、不同治疗反应均会造成ARDS群体的异质性。由于ARDS的异质性受到大家的关注,不同ARDS亚型概念被提出,以期实现ARDS的个体化、精准化治疗,降低ARDS病死率。因此,本文从患者的低氧严重程度、初始发病部位、影响学特点、起病时间、炎症水平、生物学表型等方面对ARDS亚型进行阐述,以期指导临床实施个体化治疗。Acute respiratory distress syndrome is a condition of varied etiology characterized by the acute onset of hypoxemia,reduced lung compliance,noncardiogenic pulmonary edema.Although great progress has been made in drug therapy,respiratory support and stem cell application,there is still a high mortality rate.As a syndrome,the diagnostic criteria of ARDS are relatively broad,heterogeneity of ARDS population is caused by different causes,different organism conditions and different therapeutic responses Due to the heterogeneity of ARDS,the concept of different subtypes of ARDS was proposed to achieve individualized and precise treatment,reduce the mortality of ARDS.There fore,this article elaborates the ARDS phenotype from the aspects of the patient′s hypoxia severity,initial location,imaging characteristics,onset time,inflammation level,and biological phenotype,in order to guide the clinical implementation of individualized treatment.

关 键 词：急性呼吸窘迫综合征 亚型 异质性 低氧血症 

分 类 号：R563.8[医药卫生—呼吸系统]