脓毒症与急性肾损伤

Sepsis and Acute Kidney Injury

【摘要】脓毒症及脓毒性休克是临床上的急危重症。‘肾脏是脓毒性休克最常累及的器官之一，急性肾损伤（acutekidneyinjury，AKI）的发生往往让脓毒性休克雪上加霜，也是临床医生面临的重大临床挑战，危急重症的临床和科研工作者一直在对此进行孜孜不倦的研究和探索，并取得了较大的进展，如2012年KDIGO指南对AKI定义的更新和完善，脓毒性休克及AKI发病机制的进一步深入，炎症因子和免疫系统的作用逐渐明确，早期肾损伤的新型损伤生物标记NAGL、KIM-1等的发现，及早的液体复苏和抗感染治疗的重要性等，本文拟对脓毒症与AKI的最新进展进行综述，为临床诊疗提供参考。

Sepsis and septic shock are clinically critical. Kidney is one of the most commonly organ involved in septic shock. The occurrence of acute kidney injury （AKI） tends to make septic shock worse, which＇ s also a major clinical challenge to clinicians. Critical and scientific workers have been researching and exploring tirelessly and have achieved greater progress, such as the update and re- finement of the AKI definition in the 2012 KDIGO guidelines, the further development of septic shock and AKI pathogenesis, the role of inflammatory factors and the immune system, new injury biomarkers for early kidney injury, such as NAGL, KIM-1, and the importance of early fluid resuscitation and anti-infective treatment, etc., we review the latest developments in sepsis and AKI to provide reference for clinical diagnosis and treatment.