脓毒症相关急性肾损伤机制及治疗靶点的研究进展

Research Progress in Mechanism and Therapeutic Targets of Sepsis Associated Acute Kidney Injury

脓毒症是重症监护病房患者发生急性肾损伤(AKI)的主要病因之一,发生AKI的脓毒症患者的重症监护病房住院时间更长、预后更差,其原因可能与脓毒症相关AKI(SA-AKI)复杂的发病机制相关,这也导致临床难以针对其病因进行治疗。而目前所知SA-AKI机制可能与微循环障碍、炎症失调、代谢重编程以及细胞自噬、细胞焦亡、线粒体损伤和铁死亡等程序性细胞死亡过程相关。现有研究也发现了脓毒症潜在的治疗靶点,这些研究有望为脓毒症的临床治疗提供帮助,并改善脓毒症患者的预后。目前对于SA-AKI的发病机制及靶向治疗仍存在许多问题,未来仍需不断深入研究。

Sepsis is one of the main causes of acute kidney injury(AKI)for patients in the intensive care unit.Septic patients with AKI have longer hospitalization time and worse prognosis in intensive care unit.The reason may be related to the complex pathogenesis of sepsis associated AKI(SA-AKI),which also makes it difficult to treat its etiology in clinic.At present,it′s known that the SA-AKI mechanism may be related to microcirculatory disorders,inflammatory disorders,metabolic reprogramming,and programmed cell death processes such as autophagy,pyroptosis,mitochondrial damage and ferroptosis.Existing studies have also found potential therapeutic targets for sepsis,which are expected to provide help for the clinical treatment of sepsis and improve the prognosis of the patients.At present,there are still many problems about the pathogenesis and targeted treatment of SA-AKI,and further research is still needed in the future.