心肾交互中的致命联结：心肾综合征1型的研究进展

The Fatal Link in Cardiorenal Interaction: Research Progress on Cardiorenal Syndrome Type 1

摘要: 心肾综合征1型(cardiorenal syndrome type 1, CRS-1)是影响患者预后的重要临床难题，显著增加短期与长期死亡风险。本文围绕CRS-1的发病机制、危险分层与临床治疗三个方面展开综述。在机制上，重点阐述血流动力学紊乱、炎症与氧化应激、神经内分泌激活及细胞凋亡等多通路交互作用；在风险评估方面，系统总结基于基础肾功能、血流动力学指标及新型生物标志物的分层策略与常用评分工具；治疗上强调以肾功能早期恢复为核心的急性期干预与长期随访管理，并展望代谢修饰治疗及多标志物整合模型在实现个体化防治中的前景，旨在为CRS-1的早期识别和系统化管理提供理论依据与临床实践参考。

Abstract: Cardiorenal syndrome type 1 (CRS-1) represents a critical clinical challenge that profoundly influences patient outcomes and is associated with substantially elevated short- and long-term mortality. This review provides a comprehensive overview from three perspectives: pathophysiological mechanisms, risk stratification, and therapeutic strategies. Mechanistically, CRS-1 arises from the convergence of multiple pathways, including hemodynamic instability, inflammatory and oxidative stress responses, neurohormonal activation, and apoptosis. For risk assessment, current evidence supports stratification approaches based on baseline renal function, hemodynamic parameters, and novel biomarkers, complemented by established scoring systems. From a therapeutic standpoint, emphasis is placed on acute-phase interventions targeting early renal recovery, coupled with long-term surveillance and management. Furthermore, emerging strategies such as metabolic modulation and integrated multi-biomarker models hold promise for advancing individualized prevention and treatment. Collectively, these insights aim to facilitate early recognition and systematic management of CRS-1, thereby improving clinical outcomes.