一氧化氮吸入治疗急性呼吸窘迫综合征的临床疗效

王璐; 左小淑; 高文蔚; 夏文芳; 李光; 柳舟; 石昭坤; 方小雨; 李镇文; 张浩; 宋振举; 张召才; 邓医宇; 邹捍东; 詹丽英

doi:10.14188/j.1671-8852.2024.0490

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一氧化氮吸入治疗急性呼吸窘迫综合征的临床疗效

急性呼吸窘迫综合征专题研究 | 更新时间：2026-11-05

- 一氧化氮吸入治疗急性呼吸窘迫综合征的临床疗效
- Clinical efficacy of inhaled nitric oxide therapy for acute respiratory distress syndrome
- 武汉大学学报（医学版） 2025年46卷第2期页码：187-193
- 作者机构：
  
  1.武汉大学人民医院重症医学科湖北武汉 430060
  2.麻城市中医医院重症医学科湖北麻城 438300
  3.复旦大学附属中山医院急诊科/复旦大学应急救援与急危重症研究所上海 200032
  4.浙江大学医学院附属第二医院重症医学科/浙江省急危重症临床医学研究中心浙江杭州 310009
  5.南方医科大学附属广东省人民医院/广东省医学科学院重症医学科广东广州 510000
- 作者简介：
  
  王璐，女，1987—，医学博士，主要从事ARDS临床及机制研究，E‑mail: wanglu@whu.edu.cn
  詹丽英，女，1971—，医学博士，主任医师，主要从事ARDS临床及机制研究，E‑mail: zhanliying@whu.edu.cn
- 基金信息：
  
  国家重点研发计划(2021YFC2501800);国家自然科学基金资助项目(82272226);武汉市知识创新专项项目(2023020201010165);武汉大学人民医院交叉创新人才项目(JCRCZN‑2022‑017)
- DOI：10.14188/j.1671-8852.2024.0490
  中图分类号： R459.4
- 收稿：2024-07-02，
  
  纸质出版：2025-02-25
- 稿件说明：
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王璐,左小淑,高文蔚等.一氧化氮吸入治疗急性呼吸窘迫综合征的临床疗效[J].武汉大学学报（医学版）,2025,46(02):187-193.

WANG Lu,ZUO Xiaoshu,GAO Wenwei,et al.Clinical efficacy of inhaled nitric oxide therapy for acute respiratory distress syndrome[J].Medical Journal of Wuhan University,2025,46(02):187-193.
王璐,左小淑,高文蔚等.一氧化氮吸入治疗急性呼吸窘迫综合征的临床疗效[J].武汉大学学报（医学版）,2025,46(02):187-193. DOI： 10.14188/j.1671-8852.2024.0490.

WANG Lu,ZUO Xiaoshu,GAO Wenwei,et al.Clinical efficacy of inhaled nitric oxide therapy for acute respiratory distress syndrome[J].Medical Journal of Wuhan University,2025,46(02):187-193. DOI： 10.14188/j.1671-8852.2024.0490.

摘要

目的

评估一氧化氮吸入（iNO）联合标准治疗对急性呼吸窘迫综合征（ARDS）患者的影响。

方法

采集2019年1月—2024年4月的ARDS患者共406例，按照1∶1倾向性评分匹配（PSM）后，分为iNO联合标准治疗（I+S）组和标准治疗（S）组，每组各35例，评估治疗后患者的平均肺动脉压、动脉氧分压/吸入氧浓度百分比（PaO

/FiO

）、28 d死亡率等指标。

结果

在治疗24 h和48 h后，I+S组患者的平均肺动脉压显著低于S组（

0.05）。而且，I+S组的PaO

/FiO

在治疗后显著上升（

0.05）、可溶性生长刺激表达基因蛋白2（sST2）水平显著下降（

0.05）。比较两组非机械通气时间、ICU住院时间、持续性肾脏替代治疗（CRRT）和体外膜肺氧合（ECMO）使用率、28 d死亡率，差异无统计学意义（

0.05）。

结论

一氧化氮吸入联合标准治疗在改善ARDS患者的肺动脉压、氧合和心肌标志物方面显示出潜在的益处。

Abstract

Objective

To evaluate the effect of nitric oxide inhalation (iNO) combined with standard therapy on patients with acute respiratory distress syndrome (ARDS).

Methods

A total of 406 ARDS patients collected from January 2019 to April 2024 were divided into two groups: the iNO combined with standard treatment (I+S) group and the standard treatment (S) group

with 35 patients in each group

according to a 1∶1 propensity score matching (PSM). The mean pulmonary artery pressure

arterial oxygen pressure/inspiratory oxygen fraction ratio (PaO

/FiO

)

28‑day mortality

and other treatment outcomes were evaluated.

Results

After 24 and 48 hours of treatment

respectively

the mean pulmonary artery pressure in the I+S group was significantly lower than in the S group (

0.05). In addition

PaO

/FiO

in the I+S group was significantly increased after treatment (

0.05)

and the sST2 level was significantly decreased (

0.05). No significant difference was found in the duration of non⁃mechanical ventilation

length of ICU stay

use of continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (E

CMO)

and 28⁃day mortality between the two groups (

0.05).

Conclusion

iNO combined with standard therapy shows potential benefits in improving pulmonary artery pressure

oxygenation

and cardiac biomarkers in patients with ARDS.

关键词

Keywords

references

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