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急性呼吸窘迫综合征（ARDS）的特征是非心源性肺水肿和顽固性低氧血症，其病死率很高。近年来支持治疗的发展在一定程度上降低了ARDS致死率，然而治疗费用高昂、有诸多副作用及中重度ARDS高致死率等问题，限制其临床疗效，因此有必要加强特效药物的研究。ARDS的核心病理改变是炎症反应失衡以及肺血管内皮和肺泡上皮屏障损害。调控炎症反应的强度和促进内皮和上皮屏障成为当前药物治疗ARDS的两个关键因素。本文从炎症反应失控及肺泡上皮和肺血管内皮屏障破坏两方面，总结了ARDS的发病机制以及近年来相关的临床前药物研究成果，以期为ARDS的治疗提供参考。“,”Acute respiratory distress syndrome (ARDS) is a serious disease with high mortality, which is characterized by non-cardiogenic pulmonary edema and hypoxemia. In recent years, the development of supportive therapy has reduced the mortality to some extent, however, the high cost of treatment, side effects and the high mortality of moderate and severe ARDS limit its efficacy. So it is necessary to strengthen the research on specific drugs. The core pathological changes of ARDS are the uncontrolled inflammatory response and the impairment of pulmonary vascular endothelium and alveolar epithelial barrier function. Therefore, regulating the intensity of inflammatory response and promoting the endothelial and epithelial barrier have become two key factors in the current drug treatment of ARDS. This article summarizes the pathogenesis of ARDS and the related preclinical drug therapy of ARDS in recent years from two aspects: the uncontrolled inflammatory response and the destruction of alveolar epithelial and pulmonary vascular endothelial barrier, in order to provide reference for the later treatment of ARDS.