急性肾损伤生物标志物的研究现状及新进展

Research Status and Recent Progress of Biomarkers in Acute Kidney Injury

急性肾损伤(AKI)是住院患者尤其危重症患者的常见病,发病率和病死率较高。由于血清肌酐值和尿量变化在早期诊断AKI和评判预后等方面存在不足,因此寻找并获得有潜力的AKI生物标志物可对临床实践有诸多帮助,但也存在一定的局限性。近年来,相继被发现一些新型AKI生物标志物,如细胞周期阻滞标志物(金属蛋白酶组织抑制因子2和胰岛素样生长因子结合蛋白7)、基质金属蛋白酶7、微RNA、血管紧张素原等,在评估AKI进展和不同病因引起的AKI方面具有应用前景。联合评估多种生物标志物不仅能明显提高早期诊断AKI的敏感性和特异性,对预测预后也更具优势。

Acute kidney injury(AKI) is a common disease in hospitalized patients,especially critically ill patients,with a high incidence and mortality.The diagnostic criteria for AKI based on changes in serum creatinine and urine volume is insufficient in early diagnosis and evaluation of prognosis.Finding and obtaining potential AKI biomarkers,can help the clinical practice,while it also has certain limitations.In recent years,several new AKI biomarkers have been discovered,such as cell cycle arrest markers(tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7),matrix metalloproteinase 7,microRNA,angiotensinogen and so on,with application prospects in assessing the disease progression and AKI caused by different causes.The combined evaluation of multiple biomarkers not only significantly improves the sensitivity and specificity of the early diagnosis of AKI,but also has an advantage in predicting the prognosis.