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造成对比剂肾病的危险因素主要取决于患者现存的疾病状态和对比剂的理化性质。预防对比剂肾病的首要措施是全面了解患者病情及其危险分层。发生对比剂肾病的主要危险因素包括原有的肾功能不全、糖尿病和对比剂剂量等,对比剂用量与对比剂肾病发病率密切相关。对比剂肾病的发病机制尚未完全阐明,目前,惟一广泛接受的有效减少对比剂肾病发生的方法是造影术前后水化疗法;另外,一些中等规模的临床试验和对比性研究显示,应用抗氧化剂(如N乙-酰半胱氨酸和维生素C)也具有预防对比剂肾病的作用。尽管尽量避免促发对比剂肾病的危险因素,但其在高危人群的发病率仍>25%,且病死率较高。
The risk factors for contrast-induced nephropathy depend mainly on the patient’s existing disease status and the physiochemical properties of the contrast agent. The primary measure to prevent contrast-induced nephropathy is to fully understand the patient’s condition and its risk stratification. The main risk factors for occurrence of contrast agent nephropathy include the original renal insufficiency, diabetes and contrast agent dosage, contrast agent dosage and contrast agent nephropathy incidence is closely related. The pathogenesis of contrast agent nephropathy has not yet been fully elucidated. At present, the only widely accepted method of effectively reducing the incidence of contrast-induced nephropathy is preoperative and postoperative hydration therapy. In addition, some medium-scale clinical trials and comparative studies have shown that the use of antioxidants (Such as N-acetyl-cysteine and vitamin C) also have a role in the prevention of contrast agent nephropathy. Despite the avoidance of risk factors for developing contrast-induced nephropathy, the incidence of nephropathy in high-risk groups is still> 25% and mortality is high.