高密度脂蛋白胆固醇对脓毒症患者并发急性肾损伤的影响

Effect of High-Density Lipoprotein Cholesterol (HDL-C) on Concurrent Acute Kidney Injury (AKI) in Patients with Sepsis

摘要: 脓毒症(Sepsis)是由严重感染、休克、外伤及外科大手术所致的临床综合征，其本质是形成难以控制的炎症反应和免疫抑制的恶性循环，最终导致全身脏器功能衰竭，其病程进展迅速，导致的患者病死率高27%，是ICU患者死亡的主要原因。脓毒症进展过程中易并发MODS，其中最常见的并发症是急性肾损伤(acute kidney injury, AKI)。研究表明，脓毒症所引起的AKI已成为重症脓毒症患者死亡的主要因素，病死率较高，已成为重症医学所面临的难题之一。因此，在治疗脓毒症的同时，对脓毒症所引起的AKI早诊断及治疗是改善患者预后的关键因素。

Abstract: Sepsis is a clinical syndrome caused by infection, trauma, shock and major surgical surgery. In es-sence, it is a vicious circle of uncontrollable inflammatory reaction and immune suppression, which eventually leads to systemic organ failure. The course of the disease advances rapidly, leading to a high case fatality rate of 27%, which is the main cause of death in ICU patients. MODS is prone to occur during sepsis progression, and acute kidney injury (AKI) is one of the most common severe complications. Studies have shown that sepsis complicated with AKI is the primary factor of death of severe sepsis patients, and the case fatality rate of sepsis-related patients is 50%~70%, which has become a clinical problem in the field of severe disease medicine. Therefore, while actively treating sepsis, the early identification and intervention of AKI secondary to sepsis are the key factors to improve the prognosis of patients with sepsis.