创伤相关急性呼吸窘迫综合征病理生理机制与生物标志物的研究进展
Pathophysiological Mechanisms and Biomarkers of Trauma-Induced Acute Respiratory Distress Syndrome: A Research Progress Update
DOI: 10.12677/acm.2026.1641501, PDF,   
作者: 覃阳阳：吉首大学医学院，湖南 吉首；叶 俊*：中南大学湘雅医学院附属株洲医院创伤中心，湖南 株洲
关键词: 创伤；急性呼吸窘迫综合征；病理生理机制；生物标志物；Trauma； Acute Respiratory Distress Syndrome； Pathophysiological Mechanisms； Biomarkers
摘要: 创伤是诱发急性呼吸窘迫综合征(ARDS)的重要病因，其导致的呼吸衰竭严重威胁患者生命。创伤后ARDS的病理生理机制复杂，涉及失控的全身炎症反应、肺泡上皮–内皮屏障功能破坏以及凝血纤溶系统失衡等多个相互关联的环节，这些过程共同导致肺水肿和气体交换障碍。目前，尽管支持治疗有所进步，但该病的早期识别与精准干预仍是临床挑战。本文旨在系统综述创伤相关ARDS的核心病理生理机制，如肺泡液体清除障碍、免疫细胞异常活化等，并重点评述近年来在生物标志物研究领域的重要进展，包括炎症介质、上皮与内皮损伤标志物以及新型组学标志物在疾病预测、诊断和预后评估中的潜在应用价值，以期为改善创伤后ARDS的临床管理提供新的思路和理论依据。
Abstract: Trauma is a major cause of acute respiratory distress syndrome (ARDS), and the resulting respiratory failure poses a significant threat to patient survival. The pathophysiological mechanisms underlying post-traumatic ARDS are complex, involving interrelated processes such as uncontrolled systemic inflammation, disruption of the alveolar epithelial-endothelial barrier, and coagulation-fibrinolysis imbalance, which collectively lead to pulmonary edema and gas exchange impairment. Currently, despite advancements in supportive care, early identification and precise intervention for this condition remain clinical challenges. This review systematically outlines the core pathophysiological mechanisms of trauma-induced ARDS, including impaired alveolar fluid clearance and aberrant immune cell activation. It also critically evaluates recent progress in biomarker research, highlighting the potential application of inflammatory mediators, markers of epithelial and endothelial injury, and novel omics-based biomarkers in disease prediction, diagnosis, and prognostic assessment, aiming to provide new insights and a theoretical foundation for improving the clinical management of post-traumatic ARDS.
文章引用：覃阳阳, 叶俊. 创伤相关急性呼吸窘迫综合征病理生理机制与生物标志物的研究进展[J]. 临床医学进展, 2026, 16(4): 2506-2515. https://doi.org/10.12677/acm.2026.1641501

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