非心脏手术后急性肾损伤生物标志物研究进展

Nan Li, Shuangling Li, Dong-Xin Wang, Li Yang
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摘要

急性肾损伤(AKI)是非心脏手术后的常见并发症,围手术期有多种危险因素,会导致患者的短期和长期不良后果。如今,肾脏损伤的早期检测是第一步,新的生物标志物的开发使这成为可能。然而,该领域的研究主要集中在心脏外科和ICU患者身上。在这篇文章中,回顾了关于有前景的AKI生物标志物特征的现有文献,这些生物标志物目前是非心脏手术患者临床前和临床研究的重点。这些生物标志物包括中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肝型脂肪酸结合蛋白(L-FABP)、胰岛素样生长因子结合蛋白7(IGFBP-7)和金属蛋白酶组织抑制剂2(TIMP-2)。然后描述了这些生物标志物在诊断和预测AKI方面的临床表现。最后,对生物标志物引导的术后AKI高危患者介入治疗的研究进行了综述。新型生物标志物将在非心脏手术后患者AKI的诊断和治疗中发挥更重要的作用。关键词:非心脏外科;急性肾损伤;生物标志物;早期诊断;预后
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Advances of biomarkers in acute kidney injury after non-cardiac surgery
Acute kidney injury (AKI) is a common complication after non-cardiac surgery with a variety of risk factors during perioperative period, resulting in adverse short and long-term outcomes of patients. Nowadays, early detection of injury in kidney is the first priori, development of novel biomarker making this possible. However, research in this field are mainly focused on cardiac surgery and ICU patients. In this article, it was reviewed the available literature on characteristics of promising AKI biomarkers that are currently the focus of preclinical and clinical investigations in non-cardiac surgery patients. These biomarkers include neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid-binding protein (L-FABP), insulin-like growth factor-binding protein 7 (IGFBP-7) and tissue inhibitor of metalloproteinase 2 (TIMP-2). It was then described the clinical performance of these biomarkers for diagnosis and prognostication of AKI. Finally, the study on biomarker guided interventional therapy for patients at high risk of postoperative AKI was reviewed. Novel biomarker will play a more important role in the diagnosis and treatment for AKI in patients after non-cardiac surgery. Key words: Non-cardiac surgery; Acute kidney injury; Biomarker; Early diagnosis; Prognosis
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