脓毒症并发急性肾损伤的早期生物标记物的研究进展

Research advance of early biomarkers on acute kidney injury in sepsis

脓毒症是病原体侵袭机体,经由机体过度的全身炎症反应综合征以及氧化应激反应等,引起宿主免疫系统、炎症系统、凝血系统等多系统损伤,严重者可致多器官功能障碍综合征乃至死亡。急性肾损伤（acute kidney injury,AKI）是影响脓毒症预后的独立危险因素。本文综述了AKI的新的早期诊断生物标志物：钙卫蛋白、白细胞介素-18、中性粒细胞明胶酶相关脂质运载蛋白、半胱氨酸蛋白酶抑制剂C、肾损伤分子-1和富含半胱氨酸61等。这些标志物早期出现在血或尿中,具有非创伤性和敏感性等特征。

Sepsis, the most common panthogeny, is characterized as multi-system injuries like immune system, inflammatory system and coagulation system, caused by systemic inflammatory response syndrome （ SIRS） and excessive oxidative stress after the invasion of pathogen.Severe cases can lead to multiple organ dysfunction syndrome and even death.Acute kidney injury is an independent risk factor which has an influence on patients＇prognosis.Currently, the research of biomarkers of AKI is a significant field.Some new biomarkers are found to be charaterised by early appearance in blood or urine, non-traumatic and sensitivity in recent years, which contribute to their applications in early diagnosis of AKI.At present, the biomarkers of early diagnosis of AKI, such as calprotectin, interleukin-18, neutrophil gelatinase associated lipocalin （NGAL）, cysteine protease inhibitor C, kidney injury molecule-1 （KIM-1） and cysteine rich 61, are under study.The current basic research and a few clinical studies show that these indicators may have a better sensitivity .