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

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.