急性呼吸窘迫综合征的定义演变、争议及本质探讨

Evolution,controversies,and exploration of the nature of the definition of acute respiratory distress syndrome

急性呼吸窘迫综合征(ARDS)是一组病因存在较大异质性的临床综合征,指不同病因所致的弥漫性肺病导致顽固性低氧,并最终导致严重的急性呼吸衰竭。虽然对ARDS的研究和治疗有所进展,但其发病率和病死率仍然是临床不能忽视的问题。自1967年ARDS的概念提出至今,其定义几经修订,但一直存在争议,并对临床诊疗措施的落实造成影响。目前,ARDS仍然是临床诊疗中所面临的巨大挑战。本文回顾了ARDS定义的演变过程,对其目前的诊断模式和影响进行了分析和讨论,以期为基于疾病本质的ARDS基础研究与临床研究寻找方向。

Acute respiratory distress syndrome(ARDS)is a collection of clinical syndromes characterized by a variety of heterogeneous causes.It includes diffuse lung diseases of various etiologies that ultimately lead to refractory hypoxia and severe acute respiratory failure.Despite advances in research and treatment of ARDS,its incidence and mortality continue to pose significant challenges in clinical practice.Since its inception in 1967,the definition of ARDS has undergone several revisions that have generated controversy and influenced the implementation of diagnostic and treatment strategies.At present,ARDS remains a formidable obstacle to both diagnosis and treatment.This article undertakes a comprehensive review of the evolution of ARDS definitions,examines the current diagnostic paradigm,and explores its far-reaching consequences.Our aim is to identify research directions,both in the realm of basic science and clinical practice,that are consistent with the nature of this complex disorder.