目的　探讨早期诊断脓毒症急性肾损伤（AKI）生物标记物胱抑素C（CysC）、尿肾损伤分子-1（KIM-1）、血和尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）与脓毒症AKI 诊断及其预后的关系。方法　将2011 年4 月1 日至2011年7月31日住院的92 例脓毒症患儿以入院48 h 血肌酐（CR）水平为标准， 分为脓毒症AKI 组（32 例）和脓毒症非AKI 组（60 例），比较分析CysC、KIM-1及NGAL对脓毒症AKI 诊断及其预后判断的能力。 结果　脓毒症AKI 组入院2 h 血肌酐、血尿素氮、血CysC、尿KIM-1、血NGAL 及尿NGAL 水平均较脓毒症非AKI 组明显增高，差异有统计学意义（P 均<0.05）；入院48 h，除尿KIM-1 外，脓毒症AKI 组的各项指标仍高于脓毒症非AKI 组，差异有统计学意义（P 均<0.05）；入院7 d，除血肌酐外，两组各项指标的差异均无统计学意义（P>0.05）。入院2 h 时CysC、尿KIM-1、血和尿NGAL 诊断脓毒症AKI 的曲线下面积（AUC）均高于血肌酐，也高于各自48 h 时的AUC；入院48 h 的CysC、尿KIM-1、血和尿NGAL 也均可预测脓毒症AKI 的预后。 结论　血CysC、尿KIM-1、血尿NGAL 均可作为脓毒症AKI 的早期诊断指标，且与脓毒症AKI 的预后有关。各指标与CR 48 h 均有不同程度的正性相关。

Objectives　To investigate the association of the acute kidney injury (AKI) biomarkers (Cys C, KIM-1, and NGAL) with the diagnosis and prognosis of septic AKI. Methods　Ninety-two children with sepsis from April 1, 2011 to July 31, 2011 were recruited. According to the 48 h serum creatinine level after hospitalization, the children were divided into septic AKI group (32 cases) and septic non-AKI group (60 cases). The Cys C, KIM-1, and NGAL levels were comparatively analyzed to assess their abilities to diagnosis and predict the prognosis of septic AKI. Results　At 2 h after hospitalization, the levels of serum creatinine, serum urea nitrogen, serum Cys C, urine KIM-1, serum NGAL, and urine NGAL were significantly higher in septic AKI group than in septic non-AKI group (P<0.05). At 48 h after hospitalization, except the urine KIM-1, the levels of other biomarkers were still significantly higher in septic AKI group than in septic non-AKI group (P<0.05). On 7 d after hospitalization, except the serum creatinine, the levels of other biomarkers were no significant difference between two groups (P>0.05). The AUCs of serum Cys C, urine KIM-1, serum NGAL, and urine NGAL at 2 h after hospitalization were larger than that of serum creatinine and also larger than each of AUCs at 48 h after hospitalization in the diagnosis of septic AKI. The serum Cys C, urine KIM-1, serum NGAL, and urine NGAL level can be used to predict the prognosis of septic AKI. Conclusions　Cys C, urine KIM-1, serum NGAL, and urine NGAL can be used as early biomarkers to diagnose and to predict the prognosis of AKI. All of biomarkers are positively correlated with serum creatinine level at 48 h hospitalization.