新生儿急性肾损伤诊断生物标志物研究进展
Advances in Diagnostic Biomarkers for Neonatal Acute Kidney Injury
DOI: 10.12677/acm.2026.1641361, PDF,   
作者: 王 旭, 李晓文*：重庆医科大学附属儿童医院新生儿科，儿童少年健康与疾病国家临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿童感染与免疫罕见病重庆市重点实验室，重庆
关键词: 新生儿；急性肾损伤；生物标志物；早期诊断；Neonates； Acute Kidney Injury； Biomarker； Early Diagnosis
摘要: 急性肾损伤(AKI)是新生儿重症监护病房(NICU)中常见的危重并发症，其发生显著增加患儿死亡风险及远期慢性肾脏病发生率。目前临床依赖的血清肌酐(serum creatinine, sCr)和尿量监测存在灵敏度低、滞后性明显等固有局限，难以实现早期预警。因此，探寻能够实现早期、准确诊断的新型生物标志物已成为该领域的研究热点。本文系统综述了中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、胱抑素C (CysC)、肾损伤分子-1 (KIM-1)、白细胞介素-18 (IL-18)、肝型脂肪酸结合蛋白(L-FABP)及金属蛋白酶组织抑制剂-2与胰岛素样生长因子结合蛋白7复合物(TIMP-2·IGFBP7)在新生儿AKI早期诊断中的研究进展，重点阐述各标志物的病理生理机制、诊断效能及临床应用的优劣势，以期为提升新生儿AKI的早期识别与精准干预能力提供理论依据。
Abstract: Acute kidney injury (AKI) is a prevalent and critical complication in the neonatal intensive care unit (NICU), significantly associated with increased mortality and long-term risk of chronic kidney disease. Current diagnostic methods relying on serum creatinine (sCr) and urine output monitoring are limited by poor sensitivity and significant delays, hindering early detection. Consequently, the identification of novel biomarkers for timely and accurate diagnosis has become a research priority. This review systematically examines the progress of key biomarkers for early neonatal AKI diagnosis, including neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CysC), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), liver-type fatty acid-binding protein (L-FABP), and the complex of tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7 (TIMP-2·IGFBP7). We focus on their pathophysiological mechanisms, diagnostic performance, and the advantages and limitations associated with their clinical application, aiming to provide a theoretical basis for improving early identification and precision intervention in neonatal AKI.
文章引用：王旭, 李晓文. 新生儿急性肾损伤诊断生物标志物研究进展[J]. 临床医学进展, 2026, 16(4): 1276-1283. https://doi.org/10.12677/acm.2026.1641361

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