脓毒症相关性肾损伤

Sepsis-Associated Kidney Injury

脓毒症是重症监护病房急性肾损伤(AKI)的主要发病因素,AKI的发生可增加脓毒症患者的病死率和住院时间。脓毒症AKI的病理生理变化是多因素参与的复杂过程,包括肾脏血流动力学、内皮功能障碍、肾实质炎性细胞浸润、肾小球内血栓形成以及坏死细胞的小管充血性变化等。以中性粒细胞明胶酶脂质运载蛋白为代表的新型标志物的测定有助于AKI的早期诊断。目前,血液透析肾替代治疗是脓毒症AKI治疗的主要措施,临床集束化治疗也得到大力推广。

Sepsis is a major risk factor for acute kidney injury(AKI)in intensive care units.The development of AKI increases the mortality and length of hospital stay in sepsis patients.The pathophysiology of sepsis-associated AKI is a complex and multifactorial factor involved process,including renal hemodynamics,endothelial dysfunction,renal parenchymal inflammatory cell infiltration,glomerular thrombosis,and tubulointerstitial changes in necrotic cells.The determination of novel markers,represented by neutrophil gelatinase lipoproteins,is helpful in the early diagnosis of AKI.The hemodialysis renal replacement therapy is the main treatment of sepsis AKI at present,and care bundle has also been greatly promoted in clinical.