摘要脓毒症是儿童重症监护病房急性肾损伤(acute kidney injury,AKI)最重要的原因,AKI增加脓毒症患儿病死率和住院日数.脓毒症性AKI的发生是复杂多因素的结果,包括肾血管阻力改变、内皮损伤、炎症因子浸润等,但现阶段对病理生理的认识存在许多争议.以嗜中性粒细胞明胶酶相关脂质运载蛋白为代表的新型标记物的测定有助于AKI的早期诊断.肾替代治疗是脓毒症性AKI的主要治疗措施,但治疗的时机、模式和剂量等问题还未能达成一致观点.目前认为RIFLE分层诊断的损伤期和液体超载量达到10％ ～20％时,是开始肾替代治疗最合适的时机.

abstractsSepsis is the leading cause of acute kidney injury (AKI) in pediatric intensive care unit.Development of AKI during sepsis increased patient morbidity,predicts higher mortality and days of stay in the intensive care unit.The mechanisms behind AKI in sepsis remain controversial but were believed to be complex and multi-factorial.The pathophysiology of AKI in sepsis involved intrarenal hemodynamic changes,endothelial dysfunction,infiltration of inflammatory cytokines.The new markers of neutrophil gelatinase-associated lipocalin as the representative is helpful for early diagnosis of AKI.Renal replacement therapy (RRT)is the main treatment of sepsis related AKI.At present,the model,dose and exact timing of RRT is not well defined.A widely accepted viewpoint is that the injury stage of RIFLE diagnostic criteria and fluid overload up to 10％ ～ 20％ is the beginning of the most appropriate chance of RRT.