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1、综述：急性肾损伤的生物标志物Biomarkersofacutekidneyinjuryinanesthesia,intensivecareandmajorsurgeryAbstractAcutekidneyinjury(AKI)iscommonaftermajorsurgeryandreportedlyoccursinapproximately36%ofICUpatients.Itisassociatedwithincreasedmortality,greatercost,andprolongedIntensiveCareUnit(ICU)andhospitalstay,de
2、spiteattemptstodeveloptherapiestopreventorattenuateAKI,whichhavehadlimitedsuccess.急性肾损伤（AKI）常见于大手术和约36%的ICU患者，它增加死亡率、治疗费用和延长ICU住院时间，目前虽然正努力发展预防或减轻AKI的治疗措施，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诊断AKI的措施。传统的AKI生物标志物（肌酐和尿素氮）不能早期诊断损伤。所以，急需寻找可靠、可早期预示AKI的生物标志物。AbstractInnovativetechnologiessuchasfunctionalgenomicsandproteomicshavefacilitateddetect
4、ionofseveralpromisingearlybiomarkersofAKI,suchasneutyophilgelatinase-associatedlipocalin(NGAL),cystatinC(CyC),liver-typefattyacidbindingprotein(L-FABP),interleukin-18(IL-18),andkidneyinjurymolecule-1(KIM-1).新技术如功能基因组学和蛋白组学已帮着发现了几种有前景的，可早期提示AKI的生物标志物，如人中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、半胱氨酸蛋白酶抑制剂C（CyC）
5、、肝脏型脂肪酸结合蛋白（L-FABP）、白介素18（IL-18）和肾损伤分子1（KIM-1）。AbstractThesebiomarkershavemanypotentialapplicationsfunction,assafetymarkerstomonitortoxicityandasmeasuresoftreatmenteffect.Forexample,NGALandcystatinChavebeenusedinasafetymonitoringtrialofhydroxyethylstarchtherapyandtodetectAKIearly,duringorim
6、mediatelyaftercardiacsurgery.Clinicalusebeyondresearchsettingsisrapidlyexpanding.这些生物标志物在麻醉科和ICU中有很多潜在的应用。它们可用于评估新技术和治疗在肾功能上的影响，监测肾中毒程度和治疗效果。比如，NGAL和CyC已经用于一心脏手术期间羟乙基淀粉治疗安全监测试验以及早期预测AKI。AKIiscommonwithmajorsurgeryandcriticalillnessAKIisindependentlyassociatedwithanincreasedriskofdeathandwit
7、hprolongedlengthofstay.Severecasesrequirecostlytreatment,canresultinprolongedkidneydysfunction,andescalatethehumanandfinancialcostsofcare.Therefore,itseemsdesirabletodetectAKIasearlyaspossibleinordertodeveloporimplementpotentiallyprotectivetherapy.急性肾损伤与
