Yaganti Vamsee, Alani Firas, Yaganti Sushmita, Goldberg Sheldon, McCormick Daniel
Department of Medicine, Drexel University College of Medicine Philadelphia, PA, USA.
J Ren Care. 2009 Dec;35(4):211-8. doi: 10.1111/j.1755-6686.2009.00120.x.
Use of iodinated contrast media (ICM) for angiography can result in contrast-induced nephropathy (CIN). Gadolinium-based contrast media (GCM) have been used in angiography with a goal to reduce the incidence of CIN. We performed a retrospective analysis involving 85 patients with renal insufficiency who underwent 97 carotid artery angiography and stenting (CAAS) procedures with a combination of GCM and ICM. The incidence of peri-procedural death, Q wave myocardial infarction (QWMI), stroke and CIN were recorded. Patients in GCM group had worse preprocedure renal function compared to ICM group. There were no peri-procedural deaths or QWMI in both groups. The incidence of stroke was 2.2% in GCM group and 0% in ICM group. The incidence of CIN were similar in GCM and ICM groups (8.5% vs. 10%, respectively, p NS). However, the predicted risk of CIN was 18.5% for GCM group and 10.4% for ICM group. Use of GCM and ICM combination for CAAS resulted in a 50% reduction in the incidence of predicted CIN risk compared to ICM.
使用碘化造影剂（ICM）进行血管造影可导致造影剂肾病（CIN）。钆基造影剂（GCM）已用于血管造影，目的是降低CIN的发生率。我们进行了一项回顾性分析，纳入了85例肾功能不全患者，他们接受了97例钆基造影剂和碘化造影剂联合使用的颈动脉血管造影和支架置入术（CAAS）。记录围手术期死亡、Q波心肌梗死（QWMI）、中风和CIN的发生率。与碘化造影剂组相比，钆基造影剂组患者术前肾功能更差。两组均无围手术期死亡或Q波心肌梗死。钆基造影剂组中风发生率为2.2%，碘化造影剂组为0%。钆基造影剂组和碘化造影剂组CIN的发生率相似（分别为8.5%和10%，p无统计学意义）。然而，钆基造影剂组CIN的预测风险为18.5%，碘化造影剂组为10.4%。与碘化造影剂相比，钆基造影剂和碘化造影剂联合用于CAAS可使预测的CIN风险发生率降低50%。
