摘要
肝肾综合征(HRS)是一种影响肾脏和肝脏的多器官疾病,是终末期肝病(ESLD)的一种严重并发症,短期病死率较高,预后不良。ESLD合并多种器官功能障碍,其中肾脏疾病对长期预后的影响尤为重要。肝移植是ESLD的首选治疗方法,但ESLD合并肾功能不全的治疗更加困难并具有挑战性。因ESLD患者最终接受肝移植的人数较少,且HRS是ESLD肾衰竭的重要原因,所以早期识别和治疗肝肾综合征,可以延长不接受肝移植患者的生存时间。由于血清肌酐受多种因素的影响,不能反映肝硬化患者早期肾损伤或肾损伤的严重程度,因此寻找能够反映早期肾损伤的生物学标志物是当前临床关注的热点。目前研究较多的肾损伤生物标志物(如中性粒细胞明胶酶相关脂质运载蛋白、肾损伤因子-1、胱抑素C、白细胞介素-8和白细胞介素-18)可能有助于HRS的早期识别及鉴别诊断。
The hepatorenal syndrome(HRS)is a multi-organ disease that affects the kidney and liver.It is a serious complication of end stage liver disease(ESLD)with a high short-term mortality and a poor prognosis.Although ESLD involves multiple organ dysfunctions,the impact of kidney disease on long-term prognosis is particularly important.Liver transplantation is the primary treatment of choice for ESLD,but the combined renal insufficiency makes treatment more difficult and challenging.Considering that very few ESLD patients end up with liver transplants,and HRS is an important cause of ESLD renal failure,the early identification and treatment may prolong life of the patients who do not accept transplants.Because serum creatinine is affected by many factors,it does not reflect the severity of early renal impairment or renal dysfunction in patients with cirrhosis.Therefore,finding biomarkers that can reflect early kidney injury is a hot spot of current clinical concern.At present,biomarkers of kidney injury(such as neutrophil gelatinase-associated lipocalin,renal injury factor-1,cystatin C,interleukin-8 and interleukin-18)have been more studied which may contribute to the early stage identification and differential diagnosis of HRS.
作者
曹丽娜
万远太
CAO Lina;WAN Yuantai(Department of Gastroenterology,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430064,China)
出处
《医学综述》
2020年第12期2435-2439,2445,共6页
Medical Recapitulate
