2023 年第 3 期 第 18 卷

高原急性呼吸窘迫综合征诊断相关研究进展

Research progress on diagnosis of high-altitude acute respiratory distress syndrome

作者：郭利涛1张万奎2马四清3

英文作者：Guo Litao1 Zhang Wankui2 Ma Siqing3

单位：1西安交通大学第一附属医院重症医学科，西安710061；2青海省海东市第一人民医院重症医学科，海东810699；3青海省人民医院重症医学科，西宁810007

英文单位：1Department of Critical Care Medicine the First Affiliated Hospital of Xi′an Jiaotong University Xi′an 710061 China; 2Department of Critical Care Medicine the First People′s Hospital of Haidong Qinghai Province Haidong 810699 China; 3Department of Critical Care Medicine Qinghai Provincial People′s Hospital Xining 810007 China

关键词：急性呼吸窘迫综合征；高原肺水肿；高原疾病；诊断

英文关键词：Acuterespiratorydistresssyndrome;High-altitudepulmonaryedema;High-altitudediseases;Diagnosis

• 摘要：

• 急性呼吸窘迫综合征（ARDS）是常见的呼吸系统危重症，发病率和死亡率都很高。高原气压低、氧含量低、干燥寒冷、强辐射及气候多变的环境对人体健康有巨大的影响。高海拔地区急慢性缺氧可诱发多种疾病，ARDS的发病率也显著增加，为16.70%～20.72%。低氧是高原ARDS的诱发及加重因素。高原ARDS尽管与平原地区的ARDS有许多相似之处，但高原低压低氧的环境，造成高原ARDS独特的病理生理特征，因此其诊断标准和低海拔地区不完全相同。海拔氧合指数校正的柏林标准可以区分高原ARDS的严重程度，但仍存在争议，对于高原ARDS诊断目前仍没有统一可行的标准。本文就高原ARDS诊断方面的相关研究进展进行综述。

• Acute respiratory distress syndrome(ARDS) is a common respiratory disease with high morbidity and mortality. The plateau environment of low pressure, low oxygen, dry, cold, strong radiation and changeable climate have a huge impact on human health. Acute and chronic hypoxia at high-altitudes may induce a variety of diseases. The incidence of ARDS also increases significantly, nearly 16.70%-20.72%. Hypoxia is an inducing and aggravating factor of high-altitude ARDS. Although high-altitude ARDS has many similarities with plains ARDS, the high-altitude hypobaric and hypoxic environment Results   in unique pathophysiological characteristics of high-altitude ARDS, so its diagnostic criteria are not exactly the same as those in low-altitude areas. The oxygenation index altitude-adjusted Berlin criteria correctly identified the severity of high-altitude ARDS, however, the diagnostic criteria for high-altitude ARDS is still controversial. There is still no uniform and feasible standard for the diagnosis of high-altitude ARDS. This paper reviews the research progress on the diagnosis of high-altitude ARDS.