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  

Repeat Intravenous Administration within 2 Weeks of Iodinated Contrast Media:Effect on the Renal Function

作　　者：张保翠[1] 吴静云[1] 赵凯[1] 罗健[1] 王霄英[1] 

机构地区：[1]北京大学第一医院医学影像科,100034

出　　处：《临床放射学杂志》2017年第11期1700-1703,共4页Journal of Clinical Radiology

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。Objective To investigate the effect on renal function of repeated usage of iodinated contrast media within 2 weeks. Methods A retrospective cohort of 160 patients were studied,who were examined with contrast enhanced CT within 2 weeks. The serum creatinine level was tested before the injection of iodine contrast and 24-48 hours after the contrast media injection. The risk factors of renal impairment were recorded. MDRD equation was used to calculate the estimated glomerular filtration rate（eGFR） and contrast induced nephropathy（CIN） was evaluated. Results In the 160 patients,8（5. 00%,8/160） of them were diagnosed of CIN after the first contrast enhanced CT examination. After the second contrast injection,a further 10（6. 25%,10/160） of the subjects were diagnosed of CIN,with a cumulative 11. 25% of CIN after 2 times of iodine contrast injection. Conclusion For patients who receive iodine contrast repeatedly within 2 week,the risk of CIN is higher.

关 键 词：碘对比剂 肾功能 肾小球率过滤 对比剂肾病 

分 类 号：R816[医药卫生—放射医学]