新生儿急性肾损伤危险因素及新型生物标志物研究进展

doi:10.12372/jcp.2026.25e0928

摘要/Abstract

摘要：

新生儿急性肾损伤多见于危重儿，在新生儿重症监护室发生率约30%，死亡风险明显增加，且易进展为慢性肾病。文章主要对新生儿急性肾损伤的危险因素及相关新型生物标志物研究进展进行综述，总结不同危险因素导致的急性肾损伤的临床特点及相应生物标志物的灵敏度和特异度。新生儿急性肾损伤的发生具有多因素叠加特征，不同危险因素引起的病理机制存在差异，选择特异性生物标志物有助于早期诊断和精准干预。通过联合监测危险因素与标志物水平，早期识别急性肾损伤，以指导个体化治疗与预后评估。

关键词: 急性肾损伤, 危险因素, 生物标志物, 新生儿

Abstract:

Neonatal acute kidney injury (AKI) predominantly occurs in critically ill infants, with an incidence rate of approximately 30% in neonatal intensive care units. It is associated with a significantly increased risk of mortality and a high propensity to progress to chronic kidney disease. This review mainly summarizes recent advances in the risk factors and emerging biomarkers for neonatal AKI. Besides, this review summarizes the clinical characteristics associated with different risk factors and the sensitivity and specificity of corresponding biomarkers. The occurrence of neonatal acute kidney injury is characterized by multifactorial interactions, and the pathological mechanisms vary depending on the underlying risk factors. The use of specific biomarkers facilitates early diagnosis and precise intervention. Combined monitoring of risk factors and biomarker levels enables early identification of acute kidney injury, guiding individualized treatment and prognosis assessment.

Key words: acute kidney injury, risk factor, biomarker, neonate

中图分类号:

张文静, 王凡, 张莉, 李兰. 新生儿急性肾损伤危险因素及新型生物标志物研究进展[J]. 临床儿科杂志, 2026, 44(1): 71-78.

ZHANG Wenjing, WANG Fan, ZHANG Li, LI Lan. Advances in risk factors and novel biomarkers for neonatal acute kidney injury[J]. Journal of Clinical Pediatrics, 2026, 44(1): 71-78.

图/表 1

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分期	sCr	尿量（24 h）/ mL·kg^-1·h^-1
1期	48小时内sCr较基线值上升≥0.3 mg·dL^-1或7天内sCr较基线值上升1.5~1.9倍	<1
2期	7天内sCr较基线值上升2.0~2.9倍	<0.5
3期	7天内sCr较基线值上升3倍或sCr≥2.5 mg·dL^-1或需肾脏替代治疗	<0.3