Mintz Edward P, Gruberg Luis
Division of Invasive Cardiology, Department of Cardiology, Rambam Medical Center, Haifa 31096, Israel.
Expert Opin Pharmacother. 2003 May;4(5):639-52. doi: 10.1517/14656566.4.5.639.
Injectable and absorbable contrast media for the use in radiology, all of which contains iodine as an essential component, has been, and continues to be, one of the main sources of agents which cause hospital-acquired renal failure. Although numerous methods have been explored to prevent renal contrast damage, radiocontrast-induced nephropathy continues to be a concern in patients with existing renal insufficiency, who undergo contrast-enhanced radiographic examinations. Patients who develop contrast-induced nephropathy (CIN) have a worse prognosis and an increased risk of complications and mortality. Prevention of CIN during radiocontrast procedures continues to elude clinicians and is a chief concern during percutaneous coronary intervention, as these patients often have multiple comorbidities. A wide variety of animal and clinical investigations, and substances have been tried in order to prevent this complication, including: dialysis, contrast volume and type; adenosine antagonists; acetylcysteine; fenoldopam; and various others. The purpose of this review is to appraise all the past and current strategies employed to prevent CIN, especially during percutaneous coronary intervention.
用于放射学的可注射且可吸收的造影剂，所有这些造影剂都含有碘作为必需成分，一直是并将继续是导致医院获得性肾衰竭的主要药物来源之一。尽管已经探索了许多方法来预防肾脏造影剂损害，但对于接受造影增强放射检查的现有肾功能不全患者，放射造影剂诱发的肾病仍然是一个问题。发生造影剂诱发肾病（CIN）的患者预后较差，并发症和死亡率风险增加。在放射造影过程中预防CIN仍然困扰着临床医生，并且是经皮冠状动脉介入治疗期间的主要关注点，因为这些患者通常有多种合并症。为了预防这种并发症，已经尝试了各种各样的动物和临床研究以及物质，包括：透析、造影剂体积和类型；腺苷拮抗剂；乙酰半胱氨酸；非诺多泮；以及其他各种物质。本综述的目的是评估过去和当前用于预防CIN的所有策略，尤其是在经皮冠状动脉介入治疗期间。
