肾损伤标志物表达、作用及不同情况下的变化

Expression and effect of renal injury markers and the changes under different conditions

背景:随着新型肾损伤标志物的不断发现及其在不同肾脏疾病中的表达及作用机制的阐明,肾损伤防治取得了重要进展。目的:综述肾损伤标志物的研究进展。方法:应用计算机检索2006年1月2011年10月PubMed数据库相关文章,检索词为"renalinjury,markers",并限定文章语言种类为English。同时计算机检索2006年1月2011年10月中国期刊全文数据库相关文章,检索词为"肾损伤,标志物",并限定文章语言种类为中文。此外手工检索相关中英文会议文集。最终纳入符合标注的文献50篇。结果与结论:肾损伤标志物在不同肾疾病中的预测及表达不同,按时间、结构、功能及标本来源可将其进行不同的划分。这些标志物不仅能早期监测肾脏疾病、评估急性肾损伤,且有助于判断慢性肾损伤的转归。近年来发现的肾损伤标志物其变化均较血肌酐早,且具有较高的灵敏性和特异性,但如何筛选并应用于临床,还需深入研究其在不同个体、不同时相及不同合并症或并发症影响下的变化情况,建立肾损伤的预警平台,以期达到早期诊断和治疗肾损伤的目的。

BACKGROUND： With the development of new renal injury markers as well as the expression and mechanism in different renal diseases, an important progress has achieved in the protection of renal disease. OBJECTIVE： To summarize the research progress of renal injury markers. METHODS： The PubMed database was searched using the computer for articles published from January 2006 to October 2011 using the key words of ＂renal injury, markers＂ in English. Simultaneously, China Journal Full-text database were retrieved for articles published from January 2006 to October 2011 using the key words of ＂renal injury, markers＂ in Chinese. Besides, Conference Proceedings of English and Chinese were retrieved by hand. Finally, 50 articles were included according to the inclusion criteria. RESULTS AND CONCLUSION： The prediction and expression of the renal injury markers in different renal disease is distinct. According to time, the renal injury markers can be divided into acute and chronic kidney damage; according to the structure and function, the markers can be divided into glomerular, tubular and glomerular filtration rate; according to the source of specimen, the markers can be divided into blood, urine and tissue biopsy. These markers can not only early detect kidney disease, assess acute kidney injury and can determine the outcome of chronic renal injury. The diversification of renal injury markers is earlier than that of serum creatinine, and the renal injury markers have high sensitivity and specificity, but the screening and clinical application of renal injury markers needs further study on the changes in different individuals, different phase and different comorbidities or complications of kidney damage, and establish the early warning platform in order to achieve the purpose of early diagnosis and treatment of renal injury.