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本文复习含碘造影剂诱发急性肾功能衰竭的有关文献。其诱发因素有:肾功能不全、糖尿病、脱水、心血管疾病并使用利尿剂、高龄(70岁以上)、以及多发性骨髓瘤并脱水等。其发生机理为:血液动力学异常、肾小管内梗阻、肾小管细胞损伤、脱水引起的“肾前性”低血压,以及免疫学因素等。其预防措施包括:避免高危病人使用造影剂、避免病人脱水、延长使用造影剂的间隔时间、选用合适的造影剂和合适的剂量。
This review of iodine-containing contrast agent-induced acute renal failure related literature. Its inducing factors are: renal insufficiency, diabetes, dehydration, cardiovascular disease and the use of diuretics, elderly (over 70 years), and multiple myeloma and dehydration. The mechanism for its occurrence: hemodynamic abnormalities, tubule obstruction, tubular cell injury, dehydration caused by “prerenal” hypotension, and immunological factors. Preventive measures include: avoiding the use of contrast agents in high-risk patients, preventing the patient from dehydration, prolonging the interval between the use of contrast agents, selecting the appropriate contrast medium and the appropriate dosage.