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成人呼吸窘迫综合征(ARDS)是许多疾病的一种合并症,但诊断标准往往忽视其富有蛋白质性肺水肿的这一特点。本文用同位素双标记法(体内标记转铁蛋白和红细胞)检查41例急性肺泡浸润的病人。计算每侧肺的蛋白质积聚指数(PAI)。首批检查达到ARDS 标准的20例病人,其平均PAI 为1.67(1.40SD)/1000/min,与21例非ARDS 病人(0.67,0.76SD p<0.01),之间有显著差异.20例ARDS病人中5例未得到组织学证实者,其PAI 为0.3(0.37SD),仅1例有明显的蛋白质积聚。余15例病人PAI平均为2.13(1.32SD),首次检查14例(93.3%),第2次检查15例(100%)有明显的蛋白质积聚。21例非ARDS 病人中9例(43%)证实有明显的蛋白质积
Adult respiratory distress syndrome (ARDS) is a comorbidity of many diseases, but diagnostic criteria often overlook this characteristic of proteinaceous pulmonary edema. In this study, 41 patients with acute alveolar infiltrates were examined using the isotope dual labeling method (labeling transferrin and red blood cells in vivo). The protein accumulation index (PAI) was calculated for each lung. In the first group of 20 patients who achieved ARDS criteria, the average PAI was 1.67 (1.40 SD)/1000/min, and there was a significant difference between 21 non-ARDS patients (0.67, 0.76 SD p<0.01). 20 ARDS In 5 patients without histological confirmation, the PAI was 0.3 (0.37 SD), and only 1 patient had significant protein accumulation. The PAI of the remaining 15 patients was 2.13 (1.32 SD) on average, 14 cases (93.3%) were examined for the first time, and 15 cases (100%) on the second examination had significant protein accumulation. Nine of the 21 non-ARDS patients (43%) demonstrated significant protein production