Abstract: ObjectiveTo investigate the relationship between the subtypes of the receptor for advanced glycation end-products (RAGE) and the prognosis of acute respiratory distress syndrome (ARDS) patients. MethodsA total of 40 patients who were diagnosed with ARDS and admitted into the intensive care unit (ICU) in our hospital were enrolled. They were divided into a survival subgroup and a non-survival subgroup, according to their mortality within 28 days. Meanwhile, another 25 non-ARDS patients under the mechanical ventilation were selected as a control group. Then, blood gas analysis was performed to calculate the oxygenation index (PaO2/FiO2) within 6 hours after admission. Also, the Acute Physiology and Chronic Health EvaluationⅡ(APACHE Ⅱ) score and Murray score were determined within 24 hours. The levels of soluble RAGE (sRAGE) and endogenous RAGE (esRAGE) were measured by ELISA. ResultsCompared with the non-ARDS patients under the mechanical ventilation, ARDS patients produced remarkably increased levels of plasma sRAGE and decreased levels of plasma esRAGE (P＜0.05). For ARDS patients, the amount of sRAGE was significantly higher in the non-survival subgroup than that in survival group (P＜0.05). According to the univariate and multivariate analysis, plasma sRAGE was the only independent risk factor for the prognosis of ARDS. Meanwhile, the plasma level of sRAGE was independent of age, gender, heart rate, APACHE II score, Murray score and the level of plasma esRAGE. ConclusionsIncreases in the level of plasma sRAGE and decreases in the level of plasma esRAGE can facilitate the clinical diagnosis of ARDS. The level of plasma sRAGE is an independent risk factor for ARDS patients, which may become a biological marker that can objectively reflect the degree of lung injury and predict the prognosis of ARDS patients.