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目的评价在肾功能不全病人中进行对比增强多层螺旋CT检查的安全性。方法对938例稳定肾功能不全[估计肾小球滤过率(eGFR)为15～60mL/min)]并接受对比增强CT检查的病人进行回顾性分析。在注射对比剂前和注射后48～72h后分别测定肌酐水平。对对比剂肾病(CIN)在总研究人群中的发病率进行了评估。作为对照组,对1164例未接受注射对比剂CT检查的肾功能不全病人也进行了回顾。结果有CIN的肾功能不全的病人在研究人群中的总发病率是6.1%;eGFR为45～60、30～45和≤30mL/min病人的发病率分别为4.4%、10.5%、10.0%(P<0.01)。在对照组中,5.8%的病人血肌酐水平表现从基线水平的增加。肌酐水平的增加,在接受和未接受对比增强CT检查的病人中没有表现出显著的区别(P=0.82)。结论肾功能不全病人行对比增强多层螺旋CT扫描造成CIN的风险似乎较低,CIN病人与没有接受对比增强CT病人的发病率相比没有显著差异。
Objective To evaluate the safety of multi-slice spiral CT contrast-enhanced in patients with renal insufficiency. Methods A retrospective analysis of 938 patients with stable renal insufficiency (estimated glomerular filtration rate (eGFR) of 15-60 mL / min) and contrast-enhanced CT was performed. Creatinine levels were measured before and 48 to 72 hours after contrast injection. The incidence of contrast agent nephropathy (CIN) in the overall study population was assessed. As a control group, 1164 patients with renal insufficiency who did not receive CT contrast were also reviewed. Results The overall incidence of renal insufficiency in patients with CIN was 6.1% in the study population; the incidence of patients with eGFR of 45-60, 30-45, and ≤30 mL / min was 4.4%, 10.5%, 10.0%, respectively P <0.01). In the control group, serum creatinine levels increased from baseline in 5.8% of patients. The increase in creatinine levels did not show a significant difference between patients who received and did not receive contrast-enhanced CT (P = 0.82). Conclusions The contrast-enhanced multi-slice CT scan of patients with renal insufficiency seems to have a lower risk of CIN. There is no significant difference in the incidence of CIN between patients with CIN and those without contrast-enhanced CT.