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1、綜述：急性腎損傷的生物標志物Biomarkersofacutekidneyinjuryinanesthesia,intensivecareandmajorsurgeryAbstractAcutekidneyinjury(AKI)iscommonaftermajorsurgeryandreportedlyoccursinapproximately36%ofICUpatients.Itisassociatedwithincreasedmortality,greatercost,andprolongedIntensiveCareUnit(ICU)andhospitalst
2、ay,despiteattemptstodeveloptherapiestopreventorattenuateAKI,whichhavehadlimitedsuccess.急性腎損傷（AKI）常見于大手術和約36%的ICU患者，它增加死亡率、治療費用和延長ICU住院時間，目前雖然正努力發(fā)展預防或減輕AKI的治療措施，但收效甚微。AbstractOnemajorreasonforthislackofsuccessmaybetheresultofdelayedimplementationduetotheinabilitytodetectAKIearly.Traditi
3、onalbiomarkersofAKI(creatinineandurea)donotdetectinjuryearlyenough.Thus,Itisaprioritytofindreliable,earlybiomarkersthatpredictsubsequentAKI.其中主要原因是缺乏早期診斷AKI的措施。傳統(tǒng)的AKI生物標志物（肌酐和尿素氮）不能早期診斷損傷。所以，急需尋找可靠、可早期預示AKI的生物標志物。AbstractInnovativetechnologiessuchasfunctionalgenomicsandproteomicshavefa
4、cilitateddetectionofseveralpromisingearlybiomarkersofAKI,suchasneutyophilgelatinase-associatedlipocalin(NGAL),cystatinC(CyC),liver-typefattyacidbindingprotein(L-FABP),interleukin-18(IL-18),andkidneyinjurymolecule-1(KIM-1).新技術如功能基因組學和蛋白組學已幫著發(fā)現(xiàn)了幾種有前景的，可早期提示AKI的生物標志物，如人中性粒細胞明膠酶相關脂質運載蛋白（NG
5、AL）、半胱氨酸蛋白酶抑制劑C（CyC）、肝臟型脂肪酸結合蛋白（L-FABP）、白介素18（IL-18）和腎損傷分子1（KIM-1）。AbstractThesebiomarkershavemanypotentialapplicationsfunction,assafetymarkerstomonitortoxicityandasmeasuresoftreatmenteffect.Forexample,NGALandcystatinChavebeenusedinasafetymonitoringtrialofhydroxyethylstarchtherapyandto
6、detectAKIearly,duringorimmediatelyaftercardiacsurgery.Clinicalusebeyondresearchsettingsisrapidlyexpanding.這些生物標志物在麻醉科和ICU中有很多潛在的應用。它們可用于評估新技術和治療在腎功能上的影響，監(jiān)測腎中毒程度和治療效果。比如，NGAL和CyC已經用于一心臟手術期間羥乙基淀粉治療安全監(jiān)測試驗以及早期預測AKI。KeywordsKidneyfailureCreatinineUreaBiologicalmarkersLipocalinsCystatinCFatt
7、yacidbindingproteinInterleukin-18腎衰竭肌酐尿素氮生物學標志物脂質運載蛋白半胱氨酸蛋白酶抑制劑C脂肪酸結合蛋白白介素18WhytherapieshavebeenunsuccessfulThecapacityofN-acetylcysteinetopreventAKIafterradiocontrasthasbeentestedwithunconvincingresult,andthebenefitsofperioperativeIVsodiumbicarbonateinfusionincardiacsurgicalpatients
