对比剂肾病研究进展  

Research progress in contrast-induced nephropathy

作　　者：王玉萍[1] 沈世林[1] 苏东君[1] 何岳珍[1] 陈辅环 

机构地区：[1]兰州大学第一医院,730000 [2]甘肃省景泰县人民医院

出　　处：《介入放射学杂志》2017年第6期572-575,共4页Journal of Interventional Radiology

摘　　要：随着对比剂在现代医学中广泛应用,对比剂肾病(CIN)也引起临床上更多关注。肾缺血和肾小管毒性被认为是CIN发病机制。相关检测指标除血清肌酐(SCr)外,中性粒细胞明胶酶相关载脂蛋白(NGAL)、胱抑素C(Cys C)、肾损害分子-1(KIM-1)、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)和微小核糖核酸(miR NA)是最有前景的生物标志物。对比剂造影前必须评估患者自身危险因素(基础肾功能情况、糖尿病、贫血、高同型半胱氨酸等)和对比剂相关危险因素(对比剂渗透压、黏滞度、用量、应用频度等)。CIN治疗目前仍以水化疗法为主,其它方法包括他汀类、血管扩张剂、抗氧化剂、中医药等药物治疗,以及血液净化疗法。该文就CIN诊断、发病机制、危险因素和防治措施等研究进展作一简要综述。With the wide application of contrast media in modern medicine, contrast-induced nephropathy （CIN） has attracted more clinical attention. Renal ischemia and renal tubular toxicity have been considered to be the pathogenesis of C1N. The most promising biomarkcrs, except for serum creatinine, include neutrophil gelatinase associated lipocalin （NGAL）, cystatin C （Cys C）, kidney injury molecule-1 （KIM-1 ）, urine N-acetyl beta-D amino glucosidase （NAG） and micro molecular RNA （microRNA）. Before use of contrast media for angiography, both the patient＇s own risk factors and the contrast-associated risk factors should be carefully evaluated. The patient＇s own risk factors include basic renal function, diabetes, anemia, homocysteine, etc. The contrast-associated risk factors include the osmotic pressure, viscosity, dosage, application frequency of the used contrast agent, etc. At present, hydration therapy is still the main method for CIN, and other therapeutic methods include medication, such as statins, vasodilators, antioxidants, traditional Chinese medicine, etc., and blood purification therapy. This paper aims to make a brief summary about the research progress in CIN, focusing on its diagnosis, pathogenesis, risk factors and preventive measures.（J Intervent Radiol, 2017, 26： 572-575）

关 键 词：对比剂 对比剂肾病 预防 

分 类 号：R692[医药卫生—泌尿科学]