早产儿肾损伤的易感性及评估

Susceptibility and Assessment of Kidney Injury in Preterm Infants

早产儿出生时肾脏发育不成熟,肾小管功能差、肾小球滤过低,容易发生肾脏损伤。在过渡到宫外环境期间,常受胎龄、营养、宫内发育情况等方面的影响,还暴露于如围生期窒息、高氧通气、疾病和肾毒性药物等危险因素。导致早产的产前因素也可影响肾脏发育改变,其效应可与早产重叠。传统的评价指标如血清肌酐和尿量在肾损伤早期存在较差的敏感性和特异性。适当、合理且简易的非侵入性评估指标有助于更早期、更准确地识别有肾脏损伤及发展风险的早产儿,可尽早干预,以减缓疾病进展并尽可能改善预后。

Preterm infants are born with immature renal development,poor renal tubular function and low glomerular filtration,which predispose them to renal injury.During the transition to the extrauterine environment,they are often affected by gestational age,nutrition,and intrauterine development,and are also exposed to risk factors such as perina-tal asphyxia,high oxygen ventilation,diseases,and nephrotoxic drugs.Prenatal factors leading to preterm labor can also influence altered renal development,and their effects can overlap with preterm labor.Traditional assessment indi-cators such as serum creatinine and urine output have poor sensitivity and specificity in the early stages of renal in-jury.Appropriate,rational and simple non-invasive assessment indices can help to identify preterm infants at risk of renal injury and development earlier and more accurately,and can be intervened as early as possible in order to slow down disease progression and improve the prognosis as much as possible.