脓毒症相关急性肾损伤早期诊断标志物的研究现状

Biomarkers for early diagnosis of sepsis-associated acute kidney injury

脓毒症相关急性肾损伤(SA-AKI)是一种由脓毒症直接机制或由脓毒症治疗措施诱发的间接机制导致肾脏损伤的异质性综合征。目前SA-AKI研究的重点是新型诊断生物标志物的应用,包括脑啡肽原A 119-159、可溶性血栓调节蛋白、铁调素、尿血管紧张素原、单核细胞趋化蛋白-1、中性粒细胞明胶酶相关载脂蛋白、胱抑素C、肾损伤分子-1、肝型脂肪酸结合蛋白、细胞周期阻滞蛋白等。这些生物标志物与SA-AKI的发病机制相关,本文对这些早期诊断标志物的生物学功能、基础和临床研究现状,以及它们在SA-AKI危重症患者救治中的作用进行总结,旨在为临床早期识别、诊断和治疗SA-AKI提供帮助。

Sepsis-associated acute kidney injury(SA-AKI)is a heterogeneous syndrome caused by direct mechanisms of sepsis or indirect mechanisms induced by sepsis treatment,leading to kidney damage.Current research of SA-AKI focuses on the application of novel diagnostic biomarkers,including proenkephalin A 119-159,soluble thrombomodulin,hepcidin,urinary angiotensinogen,monocyte chemotactic protein-1,neutrophil gelatinase-associated lipocalin,cystatin C,kidney injury molecule-1,liver-type fatty acid-binding protein,and cell cycle arrest proteins.These biomarkers are related to the pathogenesis of SA-AKI.This paper summarizes the biological functions,basic and clinical research status of these early diagnostic markers,and their role in the treatment of critically ill SA-AKI patients,aiming to assist in the early identification,diagnosis,and treatment of SA-AKI in clinical practice.