摘要
急性肾损伤(acute kidney injury,AKI)是临床常见疾病,在危重症患者中发病率更高,导致患者病死率增加。近年来普遍应用的AKI诊断标准,均以血清肌酐(Scr)及尿量改变为依据,进行诊断及分级。但是,二者在临床应用中仍存在争议,如基础肌酐值的确定、尿量减少阈值及持续时间的判断,以及液体平衡对二者的影响等。而Scr与尿量联合应用,虽可提高AKI的诊断敏感度,有助于筛查高危AKI患者,但却降低了AKI的诊断特异度,可能误诊AKI;并且二者对住院病死率的预测能力,亦尚无确切结论。
Acute kidney injury （AKI） is very common, especially in patients in the intensive care unit （ICU） which is associated with increased mortality. In recent years, several criteria were proposed based on changes of serum creatinine （Scr） and urine output to diagnose and classify the AKI stages. However, there were also some controversies among these criteria in clinical application, such as the definition of baseline creatinine, the threshold value and persistence time of hypourocrinia, and the influence of fluid balance on Scr and urine output, etc. The combination criteria of Scr and urine output canimprove the sensitivity of AKI diagnosis and find out the high risk patients of AKI. Howevere, it decreases the specificity and misleads the clinicians. Moreover, there is no definite conclusion of which is better to predict the hospital mortality of AKI
出处
《中华重症医学电子杂志》
2017年第1期9-13,共5页
Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)
基金
北京市科学技术委员会资助项目(D101100050010058)
关键词
急性肾损伤
肌酸酐
肾小球滤过率
死亡率
诊断
尿量
Acute kidney injury
Creatinine
Glomerular filtration rate
Mortality
Diagnosis
Urine output
