儿童急性肾损伤相关新型生物标志物的研究进展

doi:10.3969/j.issn.1673-8640.2018.09.018

摘要/Abstract

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。

Abstract:

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.

Key words: Neutrophil gelatinase-associated lipocalin, Kidney injury molecule-1, Insulin-like growth factor-binding protein 7, Tissue inhibitor of metalloproteinase-2, Acute kidney injury, Child

中图分类号:

R446.1

田晓怡, 沈颖, 宋文琪. 儿童急性肾损伤相关新型生物标志物的研究进展[J]. 检验医学, 2018, 33(9): 850-856.

TIAN Xiaoyi, SHEN Ying, SONG Wenqi. Research progress in new biomarkers of pediatric acute kidney injury[J]. Laboratory Medicine, 2018, 33(9): 850-856.

图/表 1

参考文献 39

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类别	生物标志物	部位
功能性生物标志物	胱抑素C	肾小球
	视黄醇结合蛋白	近曲小管
肾小管损伤相关酶	NAG	近曲小管
上调蛋白类	KIM-1	近曲小管
	L-FABP	近曲小管
	NGAL	远曲小管、髓袢升支粗段、集合管
	IL-18	肾小管上皮细胞和集合管
	IGFBP7	肾小管上皮细胞
	TIMP-2	肾小管上皮细胞
	富半胱氨酸肝素结合蛋白61
	丛生蛋白	近曲小管和远曲小管
	Na⁺/H⁺交换器同工酶3	近曲小管
	胎球蛋白A	近曲小管

类别	生物标志物	部位
功能性生物标志物	胱抑素C	肾小球
	视黄醇结合蛋白	近曲小管
肾小管损伤相关酶	NAG	近曲小管
上调蛋白类	KIM-1	近曲小管
	L-FABP	近曲小管
	NGAL	远曲小管、髓袢升支粗段、集合管
	IL-18	肾小管上皮细胞和集合管
	IGFBP7	肾小管上皮细胞
	TIMP-2	肾小管上皮细胞
	富半胱氨酸肝素结合蛋白61
	丛生蛋白	近曲小管和远曲小管
	Na⁺/H⁺交换器同工酶3	近曲小管
	胎球蛋白A	近曲小管