【摘要】 目的：以欧美现行的急性肺损伤（ＡＬＩ）和急性呼吸窘迫综合征（ＡＲＤＳ）诊断标准为准，比较国内现行诊断标准的相似准确度。方法：回顾性地将１９９６年１月至１９９９年１０月瑞金医院外科ＩＣＵ收治的１８９例病人按有无可诱发ＡＲＤＳ的危险因素分为高危组和对照组，收集患者病史中动脉血气分析、胸部Ｘ线、呼吸频率、心功能、诊断时间和ＡＰＡＣＨＥ　Ⅱ评分等临床资料，并据此将我国的广州ＡＲＤＳ诊断标准与欧美的ＡＬＩ、ＡＲＤＳ标准作比较。结果：在高危组中，广州标准的灵敏度为８９％，特异性为８０％，准确度为８４％，但假阳性率为３４％，其主要原因是欧美标准诊断ＡＲＤＳ要求有胸部Ｘ线资料；在对照组中，广州标准的灵敏度为零。凭广州标准确定诊断时，距发病平均为３７．６ｈ±３２．２ｈ，而欧美标准为５２．２ｈ±４４.８ｈ（ＡＲＤＳ）和４９.１ｈ±４２．３ｈ（ＡＬＩ）。结论：广州标准与欧美ＡＬＩ标准近似，但有助于更早地确立诊断。我们认为广州标准不凭胸部Ｘ线资料就可诊断ＡＲＤＳ是恰当的。更多还原

【Abstract】 To assess the relative accuracy in diagnosing ARDS of the national Guangzhou criteria and the international ’Gold" criteria defined in the American-European Consensus Conference in 1992. Methods: 189 patients addmitted our surgical ICU during the period Jan. 1996 to Oct. 1999 were divided into two groups: high-risk group and control group, pertinent clinical information was collected, comprising arterial blood-gas analysis, X-ray of the chest, respiratory and cardiac parameters, APACHE Ⅱ scores and the time interval between the onset of disease and the diagnosis of ARDS. Basing on these data, the Guangzhou criteria was compared with the American-European criteria. Results: In the high-risk group, the Guangzhou criteria showed a sensitivity of 89%, a specificity of 80%, and an accuracy rate of 84%; but the false positive rate was 34%, due to the fact that the patients were devoid of X-ray information. In the control group, the Guangzhou criteria demonstrated a very low sensitivity of zero. The mean diagnostic time interval were 37.6±32.2h(Guangzhou criteria), 5 2.5h±44. 8h(American-European ARDS criteria), 49.1±42.3h(American-European ALI criteria) respectively. Conclusions: The Guangzhou criteria are close to the American-European ALI criteria, but reach the diagnosis of ARDS earlier. X-ray of the chest does not seem to be necessary for the diagnosis of ARDS.更多还原