急性呼吸窘迫综合征的亚型与精准治疗  

Subphenotypes and precision medicine in acute respiratory distress syndrome

作　　者：李待兮 张孝斌[1] 朱子锐 曾惠清[1] Li Daixi;Zhang Xiaobin;Zhu Zirui;Zeng Huiqing(Department of Respiratory and Critical Care Medicine,Zhongshan Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院呼吸与危重症医学科,厦门361004

出　　处：《中华结核和呼吸杂志》2024年第6期560-566,共7页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：福建省自然科学基金项目(2021J05280);福建省引进生科研启动经费(01102801)

摘　　要：急性呼吸窘迫综合征(ARDS)患者中存在大量复杂的异质性是药物治疗失败的主要原因。精准医学旨在通过阐述ARDS异质性的潜在机制,定义具有明确特征的ARDS患者亚型,以快速识别最有可能从针对性治疗中获益的患者群体,最大限度地提高治疗效率及减少不良反应。本综述从病因学、起病时间、影像学、病理学、氧合指数、呼吸力学、蛋白标志物、遗传学、转录组学及微生物组学等多个角度对ARDS亚型的研究现状进行阐述,以期更深入地理解ARDS的发病机制,从而指导ARDS的精准治疗。The presence of significant complex heterogeneity among patients with acute respiratory distress syndrome(ARDS)is a major reason for the failure of drug treatments.Precision medicine seeks to elucidate the potential mechanisms of ARDS heterogeneity,define subtypes of ARDS patients with specific characteristics,and rapidly identify the patient groups most likely to benefit from targeted treatments,thereby maximizing treatment efficiency and minimizing adverse reactions.This review discusses on the current state of research on ARDS subtypes from multiple perspectives,including etiology,onset time,radiology,pathology,oxygenation index,respiratory mechanics,protein biomarkers,genetics,transcriptomics,and microbiomics,with the aim of deepening the understanding of the pathogenesis of ARDS and thereby guiding precision treatment of ARDS.

关 键 词：急性呼吸窘迫综合征 精准治疗 蛋白标志物 针对性治疗 精准医学 起病时间 呼吸力学 病因学 

分 类 号：R563.8[医药卫生—呼吸系统]