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1、綜述：急性腎損傷的生物標(biāo)志物Biomarkersofacutekidneyinjuryinanesthesia,intensivecareandmajorsurgeryAbstractAcutekidneyinjury(AKI)iscommonaftermajorsurgeryandreportedlyoccursinapproximately36%ofICUpatients.Itisassociatedwithincreasedmortality,greatercost,andprolongedIntensiveCareUnit(ICU)andhospitalstay,de
2、spiteattemptstodeveloptherapiestopreventorattenuateAKI,whichhavehadlimitedsuccess.急性腎損傷（AKI）常見于大手術(shù)和約36%的ICU患者，它增加死亡率、治療費(fèi)用和延長(zhǎng)ICU住院時(shí)間，目前雖然正努力發(fā)展預(yù)防或減輕AKI的治療措施，但收效甚微。AbstractOnemajorreasonforthislackofsuccessmaybetheresultofdelayedimplementationduetotheinabilitytodetectAKIearly.Traditionalbiomar
3、kersofAKI(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(biāo)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(yù)示AKI的生物標(biāo)志物。AbstractInnovativetechnologiessuchasfunctionalgenomicsandproteomicshavefacilitateddetect
4、ionofseveralpromisingearlybiomarkersofAKI,suchasneutyophilgelatinase-associatedlipocalin(NGAL),cystatinC(CyC),liver-typefattyacidbindingprotein(L-FABP),interleukin-18(IL-18),andkidneyinjurymolecule-1(KIM-1).新技術(shù)如功能基因組學(xué)和蛋白組學(xué)已幫著發(fā)現(xiàn)了幾種有前景的，可早期提示AKI的生物標(biāo)志物，如人中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白（NGAL）、半胱氨酸蛋白酶抑制劑C（CyC）
5、、肝臟型脂肪酸結(jié)合蛋白（L-FABP）、白介素18（IL-18）和腎損傷分子1（KIM-1）。AbstractThesebiomarkershavemanypotentialapplicationsfunction,assafetymarkerstomonitortoxicityandasmeasuresoftreatmenteffect.Forexample,NGALandcystatinChavebeenusedinasafetymonitoringtrialofhydroxyethylstarchtherapyandtodetectAKIearly,duringorim
6、mediatelyaftercardiacsurgery.Clinicalusebeyondresearchsettingsisrapidlyexpanding.這些生物標(biāo)志物在麻醉科和ICU中有很多潛在的應(yīng)用。它們可用于評(píng)估新技術(shù)和治療在腎功能上的影響，監(jiān)測(cè)腎中毒程度和治療效果。比如，NGAL和CyC已經(jīng)用于一心臟手術(shù)期間羥乙基淀粉治療安全監(jiān)測(cè)試驗(yàn)以及早期預(yù)測(cè)AKI。AKIiscommonwithmajorsurgeryandcriticalillnessAKIisindependentlyassociatedwithanincreasedriskofdeathandwit
7、hprolongedlengthofstay.Severecasesrequirecostlytreatment,canresultinprolongedkidneydysfunction,andescalatethehumanandfinancialcostsofcare.Therefore,itseemsdesirabletodetectAKIasearlyaspossibleinordertodeveloporimplementpotentiallyprotectivetherapy.急性腎損傷與
