[1]杭 宇,王绍显,贾振宇,等.对比剂连续应用对颅内大血管闭塞患者肾功能影响的前瞻性研究[J].介入放射学杂志,2021,30(11):1091-1094.
 HANG Yu,WANG Shaoxian,JIA Zhenyu,et al.The effect of continuous use of iodinated contrast agent on the renal function in patients with occlusion of intracranial large artery: a prospective study[J].journal interventional radiology,2021,30(11):1091-1094.
点击复制

对比剂连续应用对颅内大血管闭塞患者肾功能影响的前瞻性研究()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年11
页码:
1091-1094
栏目:
神经介入
出版日期:
2021-11-25

文章信息/Info

Title:
The effect of continuous use of iodinated contrast agent on the renal function in patients with occlusion of intracranial large artery: a prospective study
作者:
杭 宇 王绍显 贾振宇 刘兴龙 王 斌 周 春 施海彬 刘 圣
Author(s):
HANG Yu WANG Shaoxian JIA Zhenyu LIU Xinlong WANG Bin ZHOU Chun SHI Haibin LIU Sheng
Department of Interventional Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, China
关键词:
【关键词】 急性缺血性脑卒中 对比剂 血管内治疗 肾功能
文献标志码:
A
摘要:
【摘要】 目的 评价连续应用等渗性对比剂对急性前循环大血管闭塞性脑卒中患者肾功能的影响。方法 本项目为单中心前瞻性设计注册研究(ClinicalTrials.gov,NCT03132558)。选取2016年9月至2018年5月在南京医科大学第一附属医院脑卒中绿色通道诊治的急性缺血性脑卒中(AIS)患者。根据检查和治疗方法,将患者分为CTA组(入院后仅接受头颅CTA评估颅内血管情况)和DSA组(入院头颅CTA明确颅内前循环大血管闭塞后即行血管内治疗)。两组患者应用同一等渗性对比剂。比较患者术前和对比剂应用后48 h血清肌酐(SCr)值,观察对比剂肾病(CIN)发生率。结果 共纳入309例患者,其中CTA组194例,DSA组115例。CTA组、DSA组患者对比剂平均应用剂量分别为(93.4±9.2) mL、(187.3±18.7) mL(P<0.05);基线SCr均值分别为(76.4±26.9) μmol/L、(74.7±27.5) μmol/L(P=0.588),对比剂应用48 h后分别为(75.1±26.0) μmol/L、(81.5±69.5) μmol/L(P=0.249)。17例患者(5.5%)发生CIN,其中CTA组7例(3.6%),DSA组10例(8.7%)(P=0.058)。结论 急性前循环大血管闭塞性脑卒中患者短期内连续应用等渗性对比剂未显著增加CIN发病率。

参考文献/References:

[1] Mohammed NM, Mahfouz A, Achkar K, et al. Contrast- induced nephropathy[J]. Heart Views, 2013, 14: 106- 116.
[2] Brinjikji W, Demchuk AM, Murad MH, et al. Neurons over nephrons systematic review and meta- analysis of contrast-induced nephropathy in patients with acute stroke[J]. Stroke, 2017, 48: 1862- 1868.
[3] Ehrlich ME, Turner HL, Currie LJ, et al. Safety of computed tomographic angiography in the evaluation of patients with acute stroke: a single- center experience[J]. Stroke, 2016, 47: 2045- 2050.
[4] Demel SL, Grossman AW, Khoury JC, et al. Association between acute kidney disease and intravenous dye administration in patients with acute stroke: a population- based study[J]. Stroke, 2017, 48: 835- 839.
[5] Qureshi A, Saleem M, Aytac E. Comparison of endovascular treatment with intravenous thrombolysis for isolated M2 segment of middle cerebral artery occlusion in acute ischemic stroke[J]. J Vasc Interv Neurol, 2017, 9: 8- 14.
[6] Yoshimura S, Sakai N, Uchida K, et al. Endovascular therapy in ischemic stroke with acute large- vessel occlusion: recovery by endovascular salvage for Cerebral Ultra- Acute Embolism Japan Registry 2[J]. J Am Heart Assoc, 2018, 7: e008796.
[7] Xiong YJ, Gong JM, Zhang YC, et al. Endovascular throm- bectomy versus medical treatment for large vessel occlusion stroke with mild symptoms: a meta- analysis[J]. PLoS One, 2018, 13: e0203066.
[8] Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2018, 49: e46- e110.
[9] 谭中宝,狄镇海. 对比剂肾病的预防——介入治疗围手术期处理[J]. 介入放射学杂志, 2012, 21:261- 264.
[10] Hall SL, Munich SA, Cress MC, et al. Risk of acute kidney injury associated with neuroimaging obtained during triage and treatment of patients with acute ischemic stroke symptoms[J]. J Neurointerv Surg, 2016, 8:1231- 1234.
[11] Sharma J, Nanda A, Jung RS, et al. Risk of contrast- induced nephropathy in patients undergoing endovascular treatment of acute ischemic stroke[J]. J Neurointerv Surg, 2013, 5: 543- 545.
[12] 杜贝贝,杨 萍. 对比剂肾病的诊治进展[J]. 中国老年学杂志,2015, 35:1150- 1152.
[13] 禤伟振,陶 涛,萧 浤,等. 心血管介入术后对比剂肾病的影响因素分析[J]. 中华放射学杂志, 2014, 48:779- 781.
[14] 张龙江,祁 吉. 对比剂肾病:一个值得关注的问题[J]. 中华放射学杂志, 2007, 41:882- 884.

相似文献/References:

[1]周 鹏,王秋林,蔡国才,等.不同温度对比剂在冠状动脉造影术中不良反应的对比观察[J].介入放射学杂志,2011,(10):769.
 ZHOU Peng,WANG Qiu-lin,CAI Guo-cai,et al.Adverse effects in coronary angiography a comparative study of different temperature contrast medium[J].journal interventional radiology,2011,(11):769.
[2]谭中宝,狄镇海.对比剂肾病的预防——介入治疗围手术期处理[J].介入放射学杂志,2012,(03):261.
 .Perioperative prevention of contrast induced nephropathy in patients undergoing interventional procedures [J].journal interventional radiology,2012,(11):261.
[3]王慧晓,徐永康,张剑平,等. 机械辅助动脉内溶栓治疗急性缺血性脑卒中[J].介入放射学杂志,2012,(08):664.
 WANG Wei- xiao,XU Yong- kang,ZHANG Jian- pin,et al. Mechanical auxiliary arterial thrombolytic therapy for the treatment of acute ischemic stroke[J].journal interventional radiology,2012,(11):664.
[4]吴 宽,虞希祥,林永胜,等.前列地尔预防对比剂肾病的实验研究[J].介入放射学杂志,2012,(11):938.
 WU Kuan,YU Xi? xiang,LIN Yong? sheng,et al. The protection of prostaglandin E1 against contrast?蛳 induced nephropathy: an experimental study[J].journal interventional radiology,2012,(11):938.
[5]许岗勤,王子亮,汪勇锋,等.导丝留置技术在急性脑动脉闭塞机械取栓中的应用[J].介入放射学杂志,2017,(03):202.
 XU Gangqin,WANG Ziliang,WANG Yongfeng,et al.The application of indwelling guide-wire technique in performing mechanical thrombectomy for acute cerebral artery occlusion[J].journal interventional radiology,2017,(11):202.
[6]张红梅,李天晓,蒯 洁,等. 采用Solitaire支架取栓术治疗急性缺血性脑卒中的手术配合[J].介入放射学杂志,2013,(10):868.
 ZHANG Hong? mei,LI Tian? xiao,KUAI Jie,et al. Nursing cooperation with the performance of Solitaire stenting removal of thrombus for the treatment of acute ischemic stroke[J].journal interventional radiology,2013,(11):868.
[7]吴 薇,吴 洁,武金玉,等. 肝转移癌射频消融治疗方案制定——超声造影的应用价值[J].介入放射学杂志,2014,(06):487.
 WU Wei,WU Jie,WU Jin- yu,et al. Application value of contrast- enhanced ultrasonography in managing liver metastases before percutaneous radiofrequency ablation treatment[J].journal interventional radiology,2014,(11):487.
[8]姜敏霞,季 中,周理余,等. 碘克沙醇用于脑血管造影及支架植入安全性观察[J].介入放射学杂志,2015,(08):720.
 JIANG Min- xia,JI Zhong,ZHOU Li- yu,et al.Iodixanol used for cerebral angiography and stent implantation: observation of its safety[J].journal interventional radiology,2015,(11):720.
[9]李英豪,彭新桂,金 晖,等.能谱CT最佳单能量图提高下肢动脉造影成像质量研究[J].介入放射学杂志,2016,(11):997.
 LI Ying- hao,PENG Xin- gui,JIN Hui,et al.The improvement of imaging quality of lower extremity angiography with optimal single energy image of spectral CT[J].journal interventional radiology,2016,(11):997.
[10]高志梅,曾勇明,孙静坤,等.不同浓度对比剂对脑血管3D-DSA成像效果的影响[J].介入放射学杂志,2016,(12):1084.
 GAO Zhi- mei,ZENG Yong- ming,SUN Jing- kun,et al.The influence of different concentration contrast media on cerebral 3D- DSA imaging quality[J].journal interventional radiology,2016,(11):1084.

备注/Memo

备注/Memo:
(收稿日期:2020- 09- 17)
(本文编辑:边 佶)
更新日期/Last Update: 2021-11-22