成人呼吸窘迫综合征12例临床分析

报告12例成人呼吸窘迫综合征（ARDS）的临床资料。本组病例共治愈4例，死亡8例，病死率为66．7％。死亡的病例均有多系统器官衰竭（MSOF），仅有1例MSOF经抢救获愈。在ARDS发生前12—24h测定外用血多形核白细胞（PMN），发现死亡组病例的PMN为17.31×109±4．77／L，显著高于治愈组8.81×109±2．35／L（P＜0．01）。提示PMN对脏器的损伤作用可能是ARDS发生、发展、启动MSOF和最终导致死亡的基本和关键的环节之一。作者认为，ARDS可以是一个独立的综合征，但常是MSOF的衰竭器官之一，后者的预后则更差。

A Clinical Analysis of 12 Cases of Adult Respiratory Distress Syndrome

Twelve cases of adult respiratory distress syndrome (ARDS) were analyzed. Among them, four cases were recoverded and eight ones were died, the mortality was66. 7%(8/12). All dead casess were complicated with multiple organ systemic failure(MOSF), but only one case complicated with MOSF in recovered group. The levels of peripheral blood neutrophils (PMN) determined in 12-24 hours prior to diagnosed ARDS indead group were much higher than those in recovered group (P<0. 01). These results suggest that the systemic damaged effects of PMN may be one of key steps in the occurrence andprogress of ARDS,and induction of MOSF which is finally leads to ultimate death. Authorconsiders that ARDS can be regarded as an independent syndrome, or as one of the failureorgansin MOSF.