急性肾损伤生物标志物在危重症患者中的研究进展

Advances of acute kidney injury biomarkers in critically ill patients

急性肾损伤(acute kidney injury,AKI)是重症监护室(intensive care units,ICU)患者的常见疾病,死亡率高。目前,改善全球肾脏病预后组织(Kidney Disease:Improving Global Outcomes,KDIGO)发布的最新AKI临床实践指南仍以血肌酐值及尿量作为AKI的诊断标准,对AKI的早期发现存在一定局限性。近年来,一些AKI生物标志物已经在临床实践中得到验证,如中性粒细胞明胶酶相关脂质运载蛋白、白介素-18、肾损伤分子-1、L型脂肪酸结合蛋白、胰岛素样生长因子结合蛋白-7和组织抑制金属蛋白酶-2、MicroRNA(miRNA)等,但因ICU中AKI患者存在更复杂的发病机制和病理生理学改变,这些生物标志物在ICU中并没有得到广泛使用,本文就AKI的新型生物标志物在ICU患者中的研究进展作一综述。

Acute kidney injury(AKI)is a common disease in intensive care units(ICU),with high mortality.At present,the latest AKI guidelines for clinical practice issued by the Kidney Disease:Improving Global Outcomes(KDIGO)are still taking serum creatinine and urine output as the diagnostic criteria of AKI,having certain limitations to early detect AKI.In recent years,some AKI biomarkers have been verified in the clinical practice,such as neutrophil gelatinase-associated lipid carrier protein,interlukin-18,kidney injury molecule-1,L-type fatty acid binding protein,insulin-like growth factor binding protein-7 and tissue inhibitory metalloproteinases-2,MicroRNA(miRNA),etc.However,these biomarkers are not widely used in ICU because AKI patients in intensive care unit(ICU)have more complicated pathogenesis and pathophysiological changes.This article reviewed the progress in new biomarkers of AKI in critically ill patients in ICU.