Department of Critical Care, Lanzhou University Second Hospital, Lanzhou, Gansu 730030, China.
Chin Med J (Engl). 2020 Apr 5;133(7):842-846. doi: 10.1097/CM9.0000000000000724.
The incidence of septic acute kidney injury (AKI) is increasing, it has become a major threat to human health because of its acute onset, poor prognosis, and high hospital costs. The most common cause of AKI in critical-care units is sepsis. Septic AKI is a complex and multi-factorial process; its pathogenesis is not fully understood. In sepsis, the destruction of mucosal barriers, intestinal flora disorders, intestinal ischemia/reperfusion injury, use of antibiotics, and lack of intestinal nutrients lead to an inflammatory reactions that in turn affects the metabolism and immunity of the host. Such changes further influence the occurrence and development of AKI. New technology is enabling various detection methods for intestinal flora. Clinical application of these methods in septic renal injury is expected to clarify the relationship among pathogenesis, disease progression mechanism, and intestinal flora.
脓毒症急性肾损伤(AKI)的发病率不断增高,因其起病急、预后差、住院费用高,已成为严重威胁人类健康的重要问题。危重症患者 AKI 最常见的原因为脓毒症。脓毒症 AKI 是一个复杂且多因素的过程,其发病机制尚未完全阐明。在脓毒症中,黏膜屏障破坏、肠道菌群紊乱、肠道缺血再灌注损伤、抗生素的使用以及肠道营养物质的缺乏导致炎症反应,进而影响宿主的代谢和免疫。这些变化进一步影响 AKI 的发生和发展。新技术使各种肠道菌群检测方法成为可能。这些方法在脓毒症肾损伤中的临床应用有望阐明发病机制、疾病进展机制和肠道菌群之间的关系。