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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。
Since 1924 when the United States successfully performed its first femoral arteriography with 50% sodium iodide, contrast media products have been constantly renewed as interventional radiology has evolved. The development of the category from ionic, non-ionic to hypertonic, isotonic and hypotonic applications from the general development of enhanced CT to coronary angiography and coronary intervention, the application of contrast has been limited to the field of diagnosis, is Gradually to the field of treatment. The use of contrast agents in the diagnosis and treatment of diseases at the same time, its side effects also affect the prognosis of patients, increasing medical costs. Currently, contrast agent nephropathy (CIN) has become the third most important cause of iatrogenic renal injury, second only to renal disease due to renal ischemia and nephrotoxic drugs. Especially for people with high-risk factors such as chronic renal insufficiency (CRI) and diabetes mellitus (DM), the incidence of CIN is significantly increased. To this end, understanding the mechanism of CIN, looking for effective preventive measures to reduce the incidence of CIN is a top priority. This article aims to discuss the research progress of CIN and provide a reference for clinicians.