脑数字减影血管造影术后患者血液及肾功能的变化
Changes in blood and renal function in patients after cerebral digital subtraction angiography.
作者信息
Marquez-Romero Juan Manuel, Zenteno Marco, Arauz Antonio
机构信息
Neurology. HGZ #2, IMSS, Aguascalientes Oriente SN, Aguascalientes 20190, Mexico.
Department of Neurological Endovascular Therapy, Instituto Nacional de Neurología y Neurocirugía "MVS, Mexico City, Mexico.
出版信息
Res Diagn Interv Imaging. 2023 Sep 1;7:100032. doi: 10.1016/j.redii.2023.100032. eCollection 2023 Sep.
OBJECTIVE
Describe the incidence of contrast-induced acute renal injury (CI-AKI) and the changes in hematocrit in a cohort of patients undergoing elective cerebral digital subtraction angiography (DSA).
METHODS
In this prospective study, patients undergoing cerebral DSA were assessed for hematocrit level and CI-AKI risk factors before the procedure and for developing CI-AKI 72 h after exposure to the contrast media.
RESULTS
Among 215 patients (109 men, mean age 36.6 years). The most frequently found CI-AKI risk factor was hypertension. There were no cases of permanent renal impairment after 14 days. Significant changes were observed in hematocrit (45.7 ± 4.9, vs. 44.5 ± 4.6, = 0.001), estimated creatinine clearance (129.7 ± 48.3, vs. 123.1 ± 40.5, = 0.002), and serum creatinine (0.72 ± 0.19, vs 0.74 ± 0.18, = 0.031). The mean change in serum creatinine 72 h after contrast administration was +0.27 ± 0.10 mg/dL ( < 0.05).
CONCLUSIONS
The incidence of CI-AKI after elective cerebral DSA was 1.4%. A significant decrease in hematocrit was observed up to 72 h after the procedure.
目的
描述择期进行脑数字减影血管造影（DSA）的患者队列中对比剂诱导的急性肾损伤（CI-AKI）的发生率以及血细胞比容的变化。
方法
在这项前瞻性研究中，对接受脑DSA的患者在手术前评估血细胞比容水平和CI-AKI危险因素，并在接触造影剂72小时后评估是否发生CI-AKI。
结果
215例患者（109例男性，平均年龄36.6岁）。最常见的CI-AKI危险因素是高血压。14天后无永久性肾功能损害病例。观察到血细胞比容（45.7±4.9，vs.44.5±4.6，P = 0.001）、估算的肌酐清除率（129.7±48.3，vs.123.1±40.5，P = 0.002）和血清肌酐（0.72±0.19，vs 0.74±0.18，P = 0.031）有显著变化。造影剂给药72小时后血清肌酐的平均变化为+0.27±0.10mg/dL（P<0.05）。
结论
择期脑DSA后CI-AKI的发生率为1.4%。术后72小时内观察到血细胞比容显著下降。
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