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早产儿急性肾损伤研究进展

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急性肾损伤(acute kidney injury,AKI)是导致早产儿死亡的高危因素之一,发病率呈逐年增加趋势,其发病机制可能与早产肾单位不足、宫内炎症损伤、尿足细胞丢失等有关.早产儿AKI的发生率随胎龄及出生体重下降而上升,需要强调的是,早产儿AKI并不是独立存在的,其与心、肺、肠道、脑等器官功能存在交互作用,这些器官的受累可增加AKI发病风险;此外,血流感染亦可增加AKI患病风险.临床实践中仍要以血肌酐及尿量作为早产儿AKI的诊断及分级依据.糖皮质激素及咖啡因对早产儿肾脏可起保护作用.由于AKI的治疗缺乏特异性,液体管理及药物使用对AKI的进展十分重要.严重AKI可予肾脏替代治疗,常见的为腹膜透析及持续肾脏替代治疗.
Advances of acute kidney injury in premature infants
Acute kidney injury(AKI)is one of the risk factors leading to death in premature infants.The incidence of AKI showed a upward trend year by year.The pathogenesis may be related to preterm birth with insufficient nephrons,prenatal inflammatory injury and urinary podocyte loss.The occurrence rate of AKI in premature infants increased with the decreasing of gestational age and birth weight.It should be emphasized that AKI in premature infants does not exist independently,but interacts with other organs,such as heart,lung,intestine,brain,and other organs.Moreover,the involvement of these organs may increase the risk of AKI,and so does bloodstream infections.Blood creatinine and urine volume can be used for clinical diagnosis and classification of AKI in premature infants.Glucocorticoids and caffeine can protect kidney in premature infants.Due to the lack of specificity in the treatment of AKI,fluid management and medication are important for the development of AKI.Renal replacement therapy,the common of which are peritoneal dialysis and continuous renal replacement therapy,can be used in severe AKI.

Acute kidney injuryPremature infantGestational ageBrith weightOrgan

牛晓婉、李禹希、汪莉、王杨、王琍琍

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安徽医科大学第一附属医院儿科,合肥 230022

急性肾损伤 早产儿 胎龄 出生体重 器官

安徽省教育厅安徽省高等学校省级质量工程项目

2022sx076

2024

国际儿科学杂志
中华医学会,中国医科大学

国际儿科学杂志

CSTPCD
影响因子:1.057
ISSN:1673-4408
年,卷(期):2024.51(4)