Adolph E, Chatterjee T, Ince H, Eckard H, Rehders T, Kische S, Drawert S, Petzsch M, Nienaber C A
Universität Rostock, Klinik und Poliklinik für Innere Medizin, Abteilung für Kardiologie.
Dtsch Med Wochenschr. 2005 Oct 21;130(42):2391-6. doi: 10.1055/s-2005-918582.
The use of diagnostic and therapeutic catheterization is increasing and so is the exposure to radiocontrast media. As a consequence, an increasing incidence of contrast media-associated nephropathy is being observed. This article reviews pathogenesis, clinical symptoms and preventive measures of contrast media-associated nephropathy. Most important prophylactic measures is identification of high-risk patients, careful selection to be exposed to contrast media, application of non-ionic low osmolality or -- most recently -- iso-osmolality contrast media, adjusted hydration with isotonic saline before/during catheter interventions, and potentially the administration of acetylcysteine.
诊断性和治疗性导管插入术的使用正在增加，接触放射性造影剂的情况也在增加。因此，与造影剂相关的肾病发病率正在上升。本文综述了与造影剂相关的肾病的发病机制、临床症状和预防措施。最重要的预防措施是识别高危患者，谨慎选择接受造影剂的患者，应用非离子型低渗或——最近——等渗造影剂，在导管介入之前/期间用等渗盐水进行适当水化，以及可能给予乙酰半胱氨酸。
