新型肾脏生物标志物在肝硬化患者急性肾损伤病因鉴别及预后中的研究进展

Research progress of novel renal biomarkers in etiological identification and prognosis of acute kidney injury in patients with cirrhosis

急性肾损伤(AKI)在晚期肝硬化中较常见,主要包括肾前氮质血症、肝肾综合征和急性肾小管坏死,肾功能评估及肾功能损伤与结构性损伤的鉴别是治疗的关键所在。血清肌酐水平的变化目前仍然是肝硬化AKI诊断金标准,但在评估肾功能方面的作用有限。新型生物标志物有望为肝硬化患者AKI提供诊断、鉴别诊断和预后有效评估。该文从诊断、AKI病因鉴别和临床预后预测的角度,对近年来肝硬化AKI肾脏生物标志物的研究作一综述。

Acute kidney injury(AKI)is common in advanced liver cirrhosis,mainly including prerenal azotemia,hepatorenal syndrome and acute tubular necrosis.The evaluation of renal function and the differentiation between renal function damage and structural damage are the key points of treatment.The change of serum creatinine level is still the gold standard for the diagnosis of AKI in cirrhosis.However,its role in evaluating the renal function is limited.The novel biomarkers are expected to provide effective diagnosis,differential diagnosis and prognosis evaluation for liver cirrhosis patients with AKI.This paper reviews the recent studies on renal biomarkers of AKI in cirrhosis from the perspectives of diagnosis,etiological identification of AKI and clinical prognosis prediction.