新冠肺炎急性肾损伤机制的研究进展

Research progress on the mechanism of acute kidney injury in novel coronavirus pneumonia

新型冠状病毒是一种传染性强,潜伏期长,高度致病性的呼吸道病毒,人群普遍易感,疫情控制难度大,引起重症、危重症及死亡病例较多,已对社会造成巨大危害。目前尚缺乏有效特异性治疗方式,除攻击肺脏出现呼吸道症状外,该病毒还会引起急性肾损伤,表现为蛋白尿、血尿、肾功能异常及肾脏影像学改变,但其感染导致肾脏损伤的机制尚不清楚,本文探讨病毒通过直接攻击肾脏、诱发细胞因子风暴、引起免疫失调、药物性损伤及循环血容量不足等因素。肾脏损伤影响新冠肺炎预后,因此,临床医师应注重肾功能监测,早期预防,早期发现及治疗。

The new coronavirus is a highly infectious,long incubation period,and highly pathogenic respiratory virus.The population is generally susceptible,and it is difficult to control the epidemic.It has caused many severe,critical illness and death cases,and has caused great harm to society.At present,there is no effective specific treatment method.In addition to attacking the lungs and causing respiratory symptoms,the virus can also cause acute kidney injury,which is manifested as proteinuria,hematuria,abnormal renal function and renal imaging changes,but the mechanism of kidney injury caused by its infection is not clear.This article discusses that it is related to factors such as direct virus attacks on the kidneys,including cytokine storms,causing immune disorders,drug-induced damage,and insufficience of circulating blood volume.Kidney damage affects the prognosis of new coronary pneumonia.Therefore,clinicians should pay attention to renal function monitoring,early prevention,early detection and treatment.