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|本期目录/Table of Contents|

对比剂肾病的研究进展

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第1期
页码:
110-113
栏目:
综述
出版日期:
2015-09-15

文章信息/Info

Title:
Status and progress of contrast media-induced nephropathy
作者:
熊 丹; 翟红霞; 李 良; 李 娜; 王 磊; 张津津; 夏云峰
（解放军总医院第一附属医院干一科，北京 100048）
Author(s):
XIONG Dan;  ZHAI Hong-xia;  LI Liang;  LI Na;  WANG Lei;  ZHANG Jin-jin;  XIA Yun-feng
(VIP Ward, First Affiliated Hospital, PLA General Hospital, Beijing 100048, China)
关键词:
对比剂肾病; 发病机制; 危险因素; 预防措施
Keywords:
Contrast-induced nephropathy;  pathogenesis;  risk factors;  protective measures
分类号:
R692
DOI:
-
文献标识码:
A
摘要:
自1924年美国用50%的碘化钠成功地做了第一例股动脉造影以来，与介入放射学的发展一样造影剂产品不断的更新换代。发展类别从离子型、非离子型至高渗、等渗及低渗，应用范围从普通的增强CT发展到冠状动脉造影术及冠状动脉介入治疗等，对比剂的应用已不局限于诊断领域，正在逐步向治疗领域发展。使用对比剂在帮助诊断治疗疾病的同时，其副作用也影响着患者的预后，增加医疗费用。目前，对比剂肾病(CIN)已成为医源性肾损害的第3大主要因素，仅次于肾缺血损伤和肾毒性药物所致的肾病。尤其是对于存在慢性肾功能不全（CRI）、糖尿病(DM)等高危因素的人群，CIN的发生率更是明显增加。为此，了解CIN的发生机制，寻找有效的预防措施，减少CIN的发生已是当务之急。本文旨在论述CIN的研究进展，为临床工作者提供参考依据。
Abstract:
Since the first successful case of femoral artery angiography using 50% sodium iodide in the United States in 1924, contrast agents have been constantly upgraded from ionic and nonionic contrast media to high, isotonic and hypotonic permeability media. Their applications range from enhanced CT to coronary angiography and coronary artery intervention therapy. Contrast agents are not limited to the field of diagnosis and are gradually applied to treatment. Along with their efficacy in diagnosis and treatment of diseases, side effects of contrast agent products can affect the prognosis and increase medical expenses. Contrast-induced nephropathy (CIN) has become the third major factor for iatrogenic renal damage, only after renal ischemia injury and drug-induced toxicity. The occurrence rate of CIN is obviously increased, especially in patients with chronic renal insufficiency, diabetes mellitus and other risk factors. This paper will discuss the clinical status and progress of contrast-induced nephropathy from the aspects of the occurrence mechanism of CIN and effective preventive measures of CIN so as to provide some reference for clinicians.

参考文献/References

[1]Morcos SK,Thomsen HS,Webb J.Contrast-media-induced nephrotoxicity:a consensus report[J].Eur Radiol,1999,9(8):1602-1613.
[2]Mccullough PA.Contrast-Induced acute kidney injury[J].J Am Coll Cardiol,2008,51(15):1419-1428.
[3]Thomsen HS, Morcos SK.Risk of contrast-medium-induced nephropathy in high-risk patients undergoing MDCT--a pooled analysis of two randomized trials[J].Eur Radiol,2009,19(4):891-897.
[4]Katzberg RW,Lamba R.Contrast-induced nephropathy after intravenous administration:fact or fiction?[J].Radiol Clin North Am,2009,47(5):789-800.
[5]胡道予.X线造影剂引起的肾病——机制、临床和预防[J].放射学实践,2000,15(2):113.
[6]Persson PB,Tepel M.Contrast medium-induced nephropathy:the pathophysiology[J].Kidney Int Suppl,2006,(100):S8-S10.
[7]Heyman SN,Brezis M,Epstein FH,et al.Early renal medullary hypoxic injury from radiocontrast and indomethacin[J].Kidney Int, 1991,40(4):632-642.
[8]el Sayed AA,Haylor JL,el Nahas AM,et al.Haemodynamic effects of water-soluble contrast media on the isolated perfused rat kidney[J].Br J Radiol,1991,64(761):435-439.
[9]Andreucci M, Fuiano G,Presta P,et al.Radiocontrast media cause dephosphorylation of Akt and downstream signaling targets in human renal proximal tubular cells[J].Biochem Pharmacol,2006,72(10):1334-1342.
[10]Sharma SK,Kini A.Effect of nonionic radiocontrast agents on the occurrence of contrast-induced nephropathy in patients with mild-moderate chronic renal insufficiency:pooled analysis of the randomized trial[J].Catheter Cardiovasc Interv,2005,65(3):386-393.
[11]Barrett BJ,Carlisle EJ.Metaanalysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media[J].Radiology,1993,188(1):171-178.
[12]Thomsen HS,Morcos SK.Risk of contrast-medium-induced nephropathy in high-risk patients undergoing MDCT--a pooled analysis of two randomized trials［J］. Eur Radiol,2009,19(4):891-897.
[13]Iheyman SN,Rosenberger C,Rosen S,et al.Why Is Diabetes Mellitus a Risk Factor for Contrast-Induced Nephropathy?[J].Biomed Res Int,2013,2013:123589.
[14]Toprak O,Cirit M,Yesil M,et al.Impact of diabetic and prediabetic state on development of contrast-induced nephropathy in patients with chronic Kidney disease[J].Nephrol Dial Transplant,2007,22(3):819-826.
[15]Cigarroa RG,Lange RA,Williams RH,et al.Dosing of contrast material to prevent contrast nephropathy in patients with renal disease[J].Am J Med,1989,86(6 Pt 1):649-652.
[16]Rudnick MR,Goldfarb S,Wexler L,et al.Nephrotoxicity of Ionic and nonionic contrast media in 1196 patients:a randomized trial. The Iohexol Cooperative Study[J].Kidney Int,1995,47(1):254-261.
[17]Minsinger KD,Kassis HM,Block CA,et al.Meta-Analysis of the effect of automated contrast injection devices versus manual injection and contrast volume on risk of Contrast-Induced nephropathy[J].Am J Cardiol,2014,113(1):49-53.
[18]Stacul F,van der Molen AJ,Reimer P,et al.Contrast induced nephropathy: updated ESUR contrast media safety committee guidelines[J].Eur Radiol,2011,21(12):2527-2541.
[19]Kooiman J,Le Haen PA,Gezgin G,et al.Contrast-induced acute kidney injury and clinical outcomes after intra-arterial and intravenous contrast administration:risk comparison adjusted for patient characteristics by design[J].Am Heart J,2013,165(5):793-799,799.e1.
[20]Balemans CE,Reichert LJ,van Schelven BI,et al.Epidemiology of contrast material-induced nephropathy in the era of hydration[J].Radiology,2012,263(3):706-713.
[21]Boucek P,Havrdova T,Oliyarnyk O,et al.Prevention of contrast-induced nephropathy in diabetic patients with impaired renal function: a randomized, double blind trial of Sodium bicarbonate versus Sodium chloride-based hydration[J].Diabetes Res Clin Pract,2013,101(3):303-308.
[22]Gomes VO,Lasevitch R,Lima VC.Hydration with Sodium bicarbonate does not prevent contrast nephropathy:a multicenter clinical trial[J].Arq Bras Cardiol,2012,99(6):1129-1134.
[23]Caixeta A,Dogan O,Weisz G.Contrast-induced nephropathy:protective role of fenoldopam[J].Clin Exp Pharmacol Physiol,2012,39(6):497-505.
[24]Sadat U,Usman A,Gillard JH,et al.Does ascorbic acid protect against contrast-induced acute kidney injury in patients undergoing coronary angiography: a systematic review with meta-analysis of randomized,controlled trials[J].J Am Coll Cardiol,2013,62(23):2167-2175.
[25]Gandhi S,Mosleh W,Abdel-Qadir H,et al.Statins and contrast-induced acute kidney injury with coronary angiography: systematic review and meta-analysis[J].Am J Med,2014,127(10):987-1000.

备注/Memo

备注/Memo:
收稿日期：2014-09-02.
通讯作者：夏云峰，主任医师，主要从事老年心血管病研究 Email：xiayf3691@sina.com
作者简介：熊丹，硕士生 Email：victoria1989dan@163.com
更新日期/Last Update: 2015-09-16