短期重复使用碘对比剂行CT增强扫描对患者肾脏功能的影响

发布时间：2018-02-17 01:54

本文关键词： 碘对比剂肾功能肾小球率过滤对比剂肾病　出处：《临床放射学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨短期(2周内)重复使用碘对比剂行CT增强扫描对患者肾脏功能的影响。方法连续搜集160例患者的资料,均在2周内重复行增强CT检查,男93例,女67例。检查前以书面调查问卷,调查并记录患者肾损害风险的临床情况。记录患者检查前2周内、第一次及第二次检查后24~72 h的血清肌酐值(Scr)。使用MDRD公式估算肾小球滤过率(eGFR),以增强后Scr超过增强前25%为标准诊断对比剂肾病(CIN)。结果 160患者中,行第一次CT增强扫描后,8例(5.00%)患者发生CIN。行第二次CT增强扫描后,另有10例(6.25%)患者发生CIN,累积CIN发生率为11.25%。结论短期(2周内)重复使用碘对比剂造成CIN的风险增高。如必需短期内重复行CT增强扫描,应有明确的临床适应证,且使用最低有效剂量,检查前后做好水化等预防措施,并监测患者肾脏功能变化。
[Abstract]:Objective to investigate the effect of repeated use of iodine contrast agent on renal function in patients within 2 weeks. Methods 160 patients (93 males) were examined repeatedly within 2 weeks. 67 cases of female. The clinical status of the risk of renal damage was investigated and recorded by a written questionnaire before the examination, and the patient's risk of renal damage was recorded within 2 weeks before the examination. The creatinine value of serum creatinine was calculated by using MDRD formula to estimate glomerular filtration rate (GFR) at 24 hours after the first and second examinations. The Scr after enhancement was more than 25% before enhancement as the standard diagnostic contrast agent for the diagnosis of nephropathy. After the first CT enhancement scan, 8 patients had CIN.After the second CT enhanced scan, there were 8 patients with CIN.After the second CT enhanced scan, The cumulative incidence of CIN was 11.25. Conclusion repeated use of iodine contrast agent in a short period of 2 weeks may increase the risk of CIN. If it is necessary to repeat CT enhanced CT scan in a short period of time, there should be a clear clinical indication. The lowest effective dose was used, hydration was done before and after examination, and renal function was monitored.
【作者单位】：北京大学第一医院医学影像科;
【分类号】：R816

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