肝肾综合征相关急性肾损伤发病机制研究及诊治进展  

Advances in pathogenesis,diagnosis and treatment of hepatorenal syndrome related acute kidney injury

作　　者：周玉超(综述) 李世军(审校) ZHOU Yuchao;LI Shijun(National Clinical Research Center for Kidney Diseases,Jinling Hospital,Nanjing 210016,China)

机构地区：[1]东部战区总医院,国家肾脏疾病临床医学研究中心,南京210016

出　　处：《肾脏病与透析肾移植杂志》2024年第3期269-274,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：江苏省肾脏病医学创新中心项目(CXZX202202)。

摘　　要：肝肾综合征(HRS)是一种有独特病理生理机制的肝硬化相关肾损害,其中,肝肾综合征相关急性肾损伤(HRS-AKI)是需要重点关注的亚型。除经典的血流动力学紊乱外,HRS-AKI的发病机制还涉及肠道细菌移位、系统性炎症、肾脏微循环障碍、肝硬化心肌病等。早期诊断和治疗可改善HRS-AKI预后,人血白蛋白联合特利加压素是目前广泛推荐的一线治疗,而肝移植是唯一的根治手段。本文就HRS-AKI新定义、诊断及分期标准、发病机制和诊治进展作一综述。Hepatorenal syndrome(HRS)is a type of cirrhosis-related renal damage with a unique pathophysiological mechanism.HRS-AKI is the subtype that needs special attention.In addition to the classical mechanisms of hemodynamic disorders,the occurrence of HRS-AKI also involves a variety of pathophysiological mechanisms such as intestinal bacterial translocation,systemic inflammation,renal microcirculation disorders and cirrhotic cardiomyopathy and so on.Early diagnosis and treatment can improve the poor prognosis of HRS-AKI.Albumin plus terlipressin is a widely recommended first-line treatment,nevertheless liver transplantation is the only definitive treatment for HRS.This article reviews the new definition,diagnostic and grading criteria,pathogenesis,and treatment of HRS-AKI.

关 键 词：晚期肝硬化 肝肾综合征 急性肾损伤 人血白蛋白 特利加压素 

分 类 号：R575.2[医药卫生—消化系统] R692[医药卫生—内科学]