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非离子造影剂在现代影像诊断和介入治疗中的应用日益增多,造影剂所致的急性肾损害也明显增加。文中收集一些国内资料,针对非离子造影剂用于增强CT和用于冠脉造影或相关手术如冠状动脉介入术(PC I)和经皮腔内冠状动脉成形术(PTCA),在肾功能正常的高危人群或肾功能轻度损害患者中,使用了非离子造影剂对肾功能损害影响的评价。指出高危人群,特别是合并糖尿病、高尿酸患者,应警惕出现造影剂所致肾病。对于肾功能轻度损害患者,造影剂有一过性肾损害,但7~10 d可恢复。此外,对不同剂量造影剂对肾功能影响的研究,证明造影剂的肾损害可能有一定的临界值,只要造影剂的剂量不超过294 mL,一般不会造成肾功能损害。最后对造影剂可能产生的肾功能损害提出预防与应对措施。
Nonionic contrast agents are increasingly used in modern diagnostic imaging and interventional procedures. Acute renal damage caused by contrast medium is also significantly increased. In this paper, some domestic data were collected for non-ionic contrast agent for enhanced CT and for coronary angiography or related surgery such as coronary intervention (PCI) and percutaneous transluminal coronary angioplasty (PTCA), in normal renal function Of the high-risk population or patients with mild renal damage, the use of non-ionic contrast agent on the evaluation of renal impairment. Pointed out that at-risk populations, especially with diabetes, high uric acid patients, should be alert to contrast agent-induced nephropathy. For patients with mild renal damage, contrast agents have transient renal damage, but 7 ~ 10 d can be restored. In addition, studies on the effects of different doses of contrast medium on renal function demonstrate that renal damage may be compromised by contrast agents as long as the contrast agent dose does not exceed 294 mL. Finally, the possible damage to the renal function of the contrast agent put forward prevention and response measures.