摘要
急性肾损伤(AKI)是儿童住院患者常见的急重症,其发病率和死亡率都很高。AKI病程进展迅速,早期诊断和风险预测能够辅助临床医生及时开展治疗,有效改善患儿预后。传统的生物标记物血清肌酐(SCr)与肾功能相关,但不能及时反映肾脏的损伤情况。目前,许多新的、有潜力的生物标志物,如中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子1(KIM-1)、胰岛素样生长因子结合蛋白-7(IGFBP7)以及金属蛋白酶组织抑制剂-2(TIMP-2)等被广泛研究。儿童有其独特的生长发育规律,同一生物标志物在不同年龄段的基线水平不同。文章综述了这些新的AKI生物标志物的病理生理学基础,在AKI患儿早期诊断、风险分层、预后评估中的应用及其与成人患者的差异。
Acute kidney injury(AKI)is a common critical disease with high morbidity and mortality in hospitalized children.AKI has fast progress,and early diagnosis and risk prediction can assist clinical physicians in starting timely therapy and could effectively improve patients'prognosis.Traditional biomarker,serum creatinine,is related with renal function,but it can not timely reflect kidney injury.Recently,many new potential biomarkers have been widely investigated,such as neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),insulin-like growth factor-binding protein 7(IGFBP7)and tissue inhibitor of metalloproteinase-2(TIMP-2).Children have their own unique growth and development rules.These biomarkers are at different baseline levels in different ages.This review summarizes the pathophysiological basis of these new AKI biomarkers,the application in the early diagnosis,risk stratification and prognostic evaluation of pediatric AKI and the difference for clinical performance compared with adult patients.
作者
田晓怡
沈颖
宋文琪
TIAN Xiaoyi;SHEN Ying;SONG Wenqi(Department of Clinical Laboratory,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China;Department of Nephrology,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)
出处
《检验医学》
CAS
2018年第9期850-856,共7页
Laboratory Medicine
基金
首都卫生发展科研专项基金资助项目(首发2016-2-2096)
北京市医院管理局"青苗"计划专项(QML20171205)
首都医科大学附属北京儿童医院苗圃计划资助项目(BCHYIPB-2016-01)
