摘要
由于早产儿出生时肾脏尚未发育完全,且易受到母体等因素干扰,对于早产儿急性肾损伤(acute kidney injury,AKI)尚无明确的诊断“金标准”,不论是2004年的RIFLE(risk,injury,failure,loss,end stage renal disease,RIFLE)分级诊断标准、2007年的急性肾损伤网络(Acute Kidney Injury Network,AKIN)还是2012年的改善全球肾脏疾病预后组织(Kidney Disease:Improving Global Outcomes,KDIGO)参考标准,均以血清肌酐(serum creatinine,Scr)增高或尿量(urine output,UOP)减少作为基准。诊断AKI的传统肾功能指标不仅是一种有创性操作,而且存在时间延迟,故仅依据血清肌酐及尿量显然不合理。近年来,随着人们对早产儿AKI及其远期并发慢性肾脏病(chronickidney diseae,CKD)认知的提高,许多早期预测及远期随访的方法逐渐在早产儿中运用。本文主要对早产儿的肾发育、AKI的早期肾脏损伤标志物及远期并发症随访等进行评述,以供相关专业人员开展基础与临床研究提供参阅、借鉴。
Since the kidney of preterm infants is not fully developed at birth and susceptible to maternal factors,there is no clear“gold standard”for the diagnosis of acute kidney injury(AKI)in preterm infants,whether RIFLE(risk,iniury,failure,loss,end stage renal disease)in 2004,AKIN(Acute Kidney Injury Network)in 2007 or KDIGO(Kidney Disease:Improving Global Outcomes)refer⁃ence standard in 2012,all based on increased serum creatinine(Scr)or decreased urine output(UOP).The traditional renal function index of AKI is not only an invasive operation but also has a time delay,so it is obviously unreasonable to only rely on serum creatinine and urine volume.In recent years,with the improvement of the cognition of premature infants about AKI and its long-term complicated chronic kidney disease(CKD),many methods of early prediction and long-term follow-up methods have been gradually applied in pre⁃term infants.This paper mainly reviewed the renal development,early kidney injury markers of AKI and the follow-up of long-term complications,in order to provide reference for related professionals to carry out basic and clinical research.
作者
董文斌
杨漾
章容
DONG Wenbin;YANG Yang;ZHANG Rong(Department of Neonatology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《西南医科大学学报》
2023年第3期196-202,共7页
Journal of Southwest Medical University
基金
国家自然科学基金(81571480)
四川省科技厅重大科技专项(22ZDYF1470)
泸州市人民政府-西南医科大学科技战略合作项目(2020LZXNYDJ03)。
关键词
早产儿
急性肾损伤
早期预测
远期随访
Preterm infants
Acute kidney injury
Early prediction
Long-term follow-up
