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目的：探寻高海拔地区ARDS的发生、发展规律：方法：对西宁地区（海拔2260m）32例ARDS患者进行血液动力学监测及血气分析，测定心排指数（CI）、循环阻力（SVRI）、氧输送（DO2）、氧消耗（VO2）、氧摄取率（ER）以及临床一般资料进行分析。结果：①ARDS血液动力学里高排低阻型，随着病情发展，存活组CI、SVRI降至正常，死亡组则呈持续高动力循环状态（P＜0.01）;②氯代谢早期存活组表现为高氧耗型氧缺陷.死亡组表现为低氧供型氧缺陷，病程晚期表现为病理性氧依赖;③存活组表现为单纯性酸碱失衡，死亡组多表现为混合型酸碱失衡;④死亡组48％合并MOF;结论：持续性高动力循环、低氧供型氧缺陷、病理性氧依赖、混合型酸碱失衡提示预后不良.合并MOF是ARDS的主要死亡原因。
Objective: To explore the occurrence and development of ARDS in high altitude area.METHODS: Thirty two ARDS patients in Xining (2260m above sea level) underwent hemodynamic monitoring and blood gas analysis. Cardiac index (CI), circulating resistance (SVRI) (DO2), oxygen consumption (VO2), oxygen uptake rate (ER) and clinical data were analyzed. Results: (1) In the hemodynamics of ARDS, the high-row and low-resistive type showed that the CI and SVRI in the survivors were reduced to normal with the progression of the disease. The mortality in the deceased group showed a sustained hyperdynamic circulation (P <0.01) Hypoxic-oxygen deficit. The death group showed hypoxia-deficient oxygen deficiency, the late course of the disease manifested as pathological oxygen dependency; ③ survival group showed a simple acid-base imbalance, death group showed mixed acid-base imbalance; ④ Conclusions: Persistent hyperdynamic circulation, hypoxia-induced oxygen deficiency, pathological oxygen dependence and mixed acid-base imbalance suggest that the prognosis is poor. The combined MOF is the main cause of death in ARDS.