糖皮质激素对ARDS 有一定疗效,动物实验可基本肯定,但临床尚有争议,一般认为早期应用有效,用得越早越好。大多数ARDS 发病于休克,严重感染或创伤之后,由于组织损伤、炎症及机体的强烈应激反应,大量血管活性物质被释放,引起肺血管收缩和弥漫性血管内凝血。肺微循环障碍加上炎症,毒性物质的作用和过敏反应等因素,致使肺毛细血管的内皮损伤,通透性增加及肺泡表面活性物质的生成减少,从而导致肺水肿和大量肺泡萎缩陷闭,发生气体交换障碍和通气灌注(VA/QC)比例失调。糖皮质激素就是针对 Glucocorticoids have a certain effect on ARDS, animal experiments can be basically positive, but the clinical controversial, generally believed that the early application of effective, the sooner the better. After the onset of most ARDS in shock, severe infection or trauma, a large number of vasoactive substances are released due to tissue damage, inflammation and strong stress response of the body, resulting in pulmonary vasoconstriction and diffuse intravascular coagulation. Pulmonary microcirculation disorders coupled with inflammation, the role of toxic substances and allergic reactions and other factors, resulting in endothelial damage to the lung capillaries, increased permeability and alveolar surfactant production decreased, leading to pulmonary edema and a large number of alveolar atrophy trap, Gas exchange disorders and ventilatory perfusion (VA / QC) imbalance occurs. Glucocorticoids are targeted