心脏手术相关急性肾损伤早期生物学标志物研究进展

Biomarkers of cardiac surgery-associated acute kidney injury: a narrative review

心脏手术相关急性肾损伤(CSA-AKI)是成人心脏外科术后常见的严重并发症,目前缺乏特异性检查方式,依赖血清肌酐及尿量变化的诊断存在滞后性。近年来早期诊断CSA-AKI的生物学标志物成为研究焦点。临床研究表明,中性粒细胞凝胶酶相关脂质运载蛋白及细胞周期抑制剂诊断价值高;肝脏脂肪酸结合蛋白可用于辅助诊断CSA-AKI;微小核糖核酸有助于评估患者不良预后;生物学标志物的联合应用对CSA-AKI的发生有提示意义。CSA-AKI新型生物学标志物为临床早期诊断和及时干预提供可能,有望成为CSA-AKI诊疗新的突破口。

Cardiac surgery-related acute kidney injury(CSA-AKI) is a common and serious complication after cardiac surgery in adults. Currently, there is no specific examination method, and the diagnosis relying on serum creatinine and urine volume changes is of hysteresis. Biomarkers with the potential to predict CSA-AKI have become the focus in recent years. Clinical studies have shown that neutrophil gelatinase related lipid transporters and cell cycle inhibitors are of high diagnostic value;liver fatty acid binding protein can be used to assist in the diagnosis of CSA-AKI;microRNAs help to assess the poor prognosis of patients;the combined application of biomarkers may be used to predict the occurrence of CSA-AKI. CSA-AKI biomarkers provide the possibility for early clinical diagnosis and timely intervention, and are expected to become a new breakthrough in the diagnosis and treatment of CSA-AKI.