张志燕,杨永成

失代偿期肝硬化存在多种并发症，其中生存率最差的是肝肾综合征（Hepatorenal Syndrome，HRS）。HRS是一种主要由全身循环功能障碍引起的肾功能恶化的疾病，但近年来发现，全身炎症反应和肝硬化性心肌病在发病过程中也起着重要作用。在诊断明确后，尽快开始药物治疗尤为关键，其中血管收缩药物特利加压素和白蛋白联合使用在大多数情况下为首选治疗方案；但是肝移植是唯一治愈HRS的方法，在没有肝移植的情况下，病情将迅速恶化最终发展为死亡。早期识别HRS发生积极采取治疗，可有效降低患者死亡率；近年来，越来越多的生物学标记物和影像学标志被发现与HRS的发生、发展及预后密切相关。本文主要探讨了相关生物学标记物和影像学的研究进展，并探讨了其临床应用前景和局限性，以期为HRS的早期诊断、病情评估和治疗提供新的思路。

肝硬化；肝肾综合征（HRS）；血清生物学标记物；影像学表现；急性肾损伤

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