造影剂肾病发病机制及治疗的研究进展

摘要

近年来,由于影像学及介入医学的发展,造影剂的应用日渐增多,然而造影剂对于肾脏功能的影响不容忽视.造影剂的自身属性及细胞毒性作用造成肾脏缺血、缺氧及肾脏细胞损伤,从而使肾脏功能受损.水化治疗可明确降低造影剂肾病的发病率,乙酰半胱氨酸、他汀类药物等对于造影剂引起的肾损伤亦有一定作用,此外,造影剂的选择对于肾损伤的发病率也至关重要.然而,多巴胺、内皮素受体阻断剂、L-精氨酸及血液透析等并不能显著降低造影剂肾病发病率,甚至对于机体是有害的.%In recent years,due to the development of radiology and interventional medicine,the application of the contrast agent is increasing day by day.However,the influence of contrast agent on renal function should not be ignored.Contrast agent's own attribute and cytotoxicity can lead to renal ischemia,hypoxia and cell damage,thus causes renal impairment.The hydration treatment can reduce the incidence of contrast nephropathy,as well as acetylcysteine,statins and other medicines.In addition,the choice of the contrast agent is also very important for the incidence of kidney damage.However,the dopamine,endothelin receptor blockers,L-arginine and hemodialysis do not significantly reduce the incidence of contrast nephropathy,and are even harmful to the body.