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目的探讨短期(2周内)重复使用碘对比剂行CT增强扫描对患者肾脏功能的影响。方法连续搜集160例患者的资料,均在2周内重复行增强CT检查,男93例,女67例。检查前以书面调查问卷,调查并记录患者肾损害风险的临床情况。记录患者检查前2周内、第一次及第二次检查后24~72 h的血清肌酐值(Scr)。使用MDRD公式估算肾小球滤过率(eGFR),以增强后Scr超过增强前25%为标准诊断对比剂肾病(CIN)。结果 160患者中,行第一次CT增强扫描后,8例(5.00%)患者发生CIN。行第二次CT增强扫描后,另有10例(6.25%)患者发生CIN,累积CIN发生率为11.25%。结论短期(2周内)重复使用碘对比剂造成CIN的风险增高。如必需短期内重复行CT增强扫描,应有明确的临床适应证,且使用最低有效剂量,检查前后做好水化等预防措施,并监测患者肾脏功能变化。
Objective To investigate the effect of short-term (2 weeks) repeated iodine contrast agent CT scan on renal function in patients. Methods The data of 160 patients were collected continuously. All patients underwent repeat CT scan in 2 weeks. There were 93 males and 67 females. Before the survey, a written questionnaire to investigate and record the clinical risk of kidney damage in patients with the situation. Record the serum creatinine (Scr) 24 hours to 72 hours after the first and second exams within 2 weeks before the patient’s examination. The glomerular filtration rate (eGFR) was estimated using the MDRD formula and contrast agent nephropathy (CIN) was diagnosed with an increase in post-Scr over 25% before enhancement. Results Of the 160 patients, CIN occurred in 8 patients (5.00%) after the first CT scan. After the second CT scan, another 10 patients (6.25%) developed CIN and the cumulative CIN rate was 11.25%. Conclusions Short-term (within 2 weeks) repeated use of iodine contrast agents increases the risk of CIN. Such as the need to repeat short-term CT enhanced scan, there should be a clear clinical indications, and use the minimum effective dose, check before and after the hydration and other preventive measures, and monitoring of renal function in patients with changes.