临床常规指标对脓毒症急性肾损伤发生的预测研究

Prediction of the Occurrence of Sepsis Acute Kidney Injury by Clinical Routine Indexes

急性肾损伤(acute kidney injury,AKI)是脓毒症最常累及的器官之一,脓毒症急性肾损伤(sepsis acute kidney injury,S-AKI)发病率高、死亡率高。目前针对S-AKI的诊断主要依靠监测血清肌酐或尿量,但肌酐和尿量易受一些因素的影响,使其对S-AKI的早期诊断存在一定局限性。虽然研究发现大量新型生物标志物,但它们在临床中少见、检测复杂、价格昂贵,同时有效性仍需广泛的临床试验验证。临床中常规指标弥补了新型标志物在早期筛查上的缺陷,同时S-AKI病理生理机制的研究也取得了显著成果。本文就S-AKI的病理生理机制及目前临床中常规指标对S-AKI发生的预测进展进行综述,旨在为临床更好的认识、防治S-AKI提供一定的帮助。

Acute kidney injury(AKI)is one of the most commonly involved organs of sepsis,and the incidence and mortality of S-AKI are high.At present,the diagnosis of S-AKI mainly relies on the monitoring of serum creatinine or urine volume,but creatinine and urine volume are susceptible to some factors,which makes the early diagnosis of S-AKI limited.Although a large number of novel biomarkers have been identified,they are rare,complex and expensive to detect in the clinic,and their effectiveness still needs to be validated by extensive clinical trials.The conventional clinical indicators make up for the defects of the new markers in early screening,and the research on the pathophysiological mechanism of S-AKI has also achieved remarkable results.This article reviews the pathophysiological mechanism of S-AKI and the progress in predicting the occurrence of S-AKI by conventional clinical indicators,aiming to provide some help for better clinical understanding and prevention of S-AKI.