老年新型冠状病毒肺炎患者并发急性肾损伤的发病机制及防治  

Pathogenesis,prevention and treatment of acute kidney injury in elderly patients with COVID-19

作　　者：孔慧萍 马梦青 万辛 曹长春[1] Kong Huiping;Ma Mengqing;Wan Xin;Cao Changchun(Department of Nephrology,Sir Run Run Hospital,Nanjing Medical University,Nanjing 211166,China;Department of Nephrology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属逸夫医院肾脏内科,南京211166 [2]南京市第一医院肾脏内科,南京210006

出　　处：《中华老年医学杂志》2022年第11期1394-1399,共6页Chinese Journal of Geriatrics

基　　金：江苏省卫生健康委医学科研重点项目(ZDB2020023)。

摘　　要：新型冠状病毒肺炎(COVID-19)多种变异毒株相继出现。老年群体作为COVID-19的高危人群,更易并发急性肾损伤(AKI),且具有临床表现不典型、危重症比例高的特点。其发病机制主要包括血管紧张素转化酶2(ACE2)途径、细胞外基质金属蛋白酶诱导因子(CD147)途径,病毒直接损伤肾脏机制以及与增龄相关的肾功能减退、炎症衰老、免疫衰老以及其他非特异性机制,明显增加患者不良预后发生的风险。因此,建立AKI早期预警系统、增加疫苗接种率、营养支持、治疗原发病及体外支持治疗等防治措施对于改善预后格外重要。本文将对老年COVID-19患者并发AKI的发病机制及早期防治进行总结。With the coronavirus disease 2019(COVID-19)pandemic across the world,numerous variants have emerged.As a high-risk group for COVID-19,the elderly are prone to acute kidney injury(AKI),with atypical clinical features and high proportions of patients with critical illness.Its pathogenesis mainly includes direct damage to the kidney via the angiotensin-converting enzyme 2(ACE2)pathway,the extracellular matrix metalloproteinase inducer(CD147)pathway,and age-related renal dysfunction,inflammatory aging,immune aging and other non-specific mechanisms,which significantly increase the risk of adverse prognosis.Therefore,the establishment of an early warning system for AKI,increasing vaccination coverage,nutritional support,treatment of primary diseases,extracorporeal supportive therapy and other control measures are particularly important to prognosis improvement.This review summarized the pathogenesis,early prevention and treatment of AKI in elderly patients with COVID-19.

关 键 词：新型冠状病毒肺炎 急性肾损伤 发病机制 防治 

分 类 号：R563.1[医药卫生—呼吸系统] R692[医药卫生—内科学]