重症
词汇介绍
拓展阅读
解析
Insulin-like
释义 类胰岛素
例句 But there isa very real problem, and its name is Insulin-like Growth Factor-1 (IGF-1).
但这一个非常现实的问题，它的名字是胰岛素样生长因子-1（IGF-1）.
Growth 英 [ɡrəʊθ] 美 [ɡroʊθ]
释义 n. 增长；发展；生长；种植 [ 复数 growths ]
例句 Whether in life which Angle, I all at growth.
不论在生活的哪个角度，我都在成长。
Factor 英 [ˈfæktə(r)] 美 [ˈfæktər]
释义 n. 因素；要素；[物] 因数；代理人 ；vi. 做代理商；vt. 把…作为因素计入；代理经营；把…分解成 n. (Factor)人名；(英)法克特
例句 But this cannot be the only factor.
但这不可能是唯一的因素。
Binding 英 [ˈbaɪndɪŋ] 美 [ˈbaɪndɪŋ]
释义 n. 装订；捆绑；粘合物 ；adj. 有约束力的；捆绑的；v. 捆绑（bind的ing形式）；n. (Binding)人名；(德)宾丁
例句 I acknowledge it as binding.
我承认它有约束力。
概述
概述
IGFBP-7是一种分子量为26 kD的可溶蛋白，表达于肾脏和其他组织，其中在肾脏组织中被发现主要表达于近端小管细胞管腔刷状缘，其被认为参与细胞损伤的相关过程，包括或者在这一过程中被诱导产生。
胰岛素样生长因子结合蛋白-7除了在临床中常常与TIMP-2结合对急性肾损伤有早期诊断及评估预后作用，还对射血分数保留心衰（HFpEF）病人有一定临床临床意义，本次主要描述其相关知识。
作用机制
血清IGFBP-7是GFBP家族成员，可高亲和力地与IGF结合，拮抗IGF与其受体结合而发挥作用，参与细胞增殖、黏附、衰老、凋亡和血管生成等多种生理过程，是多种肿瘤的抑制因子。近几年来有研究报道IGFBP-7升高可加速细胞衰老，提示其可能参与心肌的老化；另外有研究报道IGFBP-7与肝纤维化的程度相关。2013年通过系统的血液蛋白质组学分析筛选发现血清IGFBP-7在心室肥厚和心衰病人中显著升高，而在正常人中表达极低。后续研究表明，IGFBP-7升高是HFrEF病人预后的影响因素，且在HFrEF病人中研究发现，血清IGFBP-7水平与心超检查左心室舒张功能不全的指标重度相关。
应用
血清IGFBP-7可推荐作为HFpEF的新的血清标志物，可用于辅助诊断和及早发现左心室舒张功能不全；血清IGFBP-7升高提示心脏舒张功能恶化。而从HFpEF的病理生理机制来说，血清IGFBP-7也可以作为NT-proBNP的补充，从不同的病理生理角度反映了疾病过程，可能有助于探索治疗HFpEF的新方法。
展望
近十年来随着药物和心脏再同步化治疗(CRT)的应用，射血分数降低的心衰(HFrEF)病人的预后已明显改善，但射 血分数保留的心衰HFpEF)病人的治疗却没有明显的进展，其中最大的难点可能在于其临床表现的多样性以及病理机制尚不明确。胰岛素样生长因子结合蛋白-7(IGFBP-7)广泛表达于人体多种组织和器官。2013年有研究报道，IGFBP-7是心室肥厚和心力衰竭等疾病的生物标记物。近期又有研究表明，IGFBP-7升高与HFrEF病人预后显著相关，但其在HFpEF中的意义尚不明确。
复制标题Metalloproteinase-2和胰岛素样生长因子结合蛋白7系列尿组织抑制剂与危重症病程中急性肾损伤的预后
发表时间：2019-10-16
影响指数：2.2
作者： Peter A. McCullough
期刊：Cardiorenal Med
Acute kidney injury (AKI) is one of the most common complications of critical illnesses occurring in 50–60% of patients admitted to the intensive care unit (ICU) and is associated with serious short- and long-term complications, including increased mortality and significant healthcare costs . Daily assessment of serum creatinine (Cr), blood urea nitrogen (BUN), and hourly urine output are common ICU standards; however, while helpful in recognizing AKI once it has occurred, these methods do not allow for anticipation of AKI or changes in management before AKI is recognized. The measurement of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) and interpretation of risk based on the product of urinary concentrations [TIMP-2] × [IGFBP7] defined as ≥Stage 2 Kidney Disease Improving Global Outcomes (KDIGO) AKI over the next 12 h. However, exposures to conditions which can result in AKI continue through the ICU has advanced the field with a single measurement in the prediction of moderate to severe AKI stay, and thus, serial measurement of [TIMP-2] × [IGFBP7] would be a clinically intuitive complement to daily serum Cr and BUN which are commonly obtained in biochemical profiles in ICU patients .Conditions such as sepsis, heart failure, or shock can be associated with AKI which can progress even in an optimally managed patient. It is also recognized that during critical illness, patients can incur a large number of additional exposures with nephrotoxic potential, often in combination and succession. For example, exposure to intravascular iodinated contrast is common upon admission as well as when there is a change in clinical status due to the use of contrast-enhanced computed tomography and angiography.
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