重复使用对比剂对肾脏损伤的临床分析-clinical analysis of renal injury caused by repeated use of contrast agents.docxVIP

第三军医大学硕士学位论文 第三军医大学硕士学位论文 2 2 Clinical study of contrast-induced nephropathy in patients undergoing repeated coronary intervention Abstract Background and objective Contrast-Induced Nephropathy (CIN) was first reported in 1954 by Bartels et al who described the onset of renal failure in a patient with multiple myeloma. Since then, thousands of CIN cases have been reported. Recent years, with the development of Interventional Medicine and Nuclear Medicine Diagnosis and Treatment, especially the rapid development of interventional diagnosis and treatment in cardiovascular disease, as the progressive clinical application of contrast agent progressive which led to the increase incidence of CIN. The incidence of CIN contributes to the third leading cause of prognosis of acute renal failure(ARF) in hospital; another major causes are surgery and hypotension. Patients who develop CIN not only have been shown to have a higher rate of in-hospital mortality but also increase the risk of other complication which contribute to the significant elevation of invalidism rate and case fatality rate and related to long-term renal insufficiency.In addition, CIN patients also need to spent more money and time in hospital. There are approximate 1 million patients receive radiography, nearly 15,0000 patients will suffer CIN and the prevalence of CIN is increasing. The reported incidence of CIN following coronary angiography ranges from 1%-50%, mainly related to the existed risk factors, including chronic renal disease, diabetes, eld, hypovolemia, anemia, hypotension, nephrotoxic drugs application, heart-failure, hypoproteinemia and so on, with more risk factors, more incidences of CIN. Because of the complexity and easily recurrent attacks of the disease, in clinical, patients may have several applications of contrast media. The renal injuries induced by contrast media are normally reversible, but it can also cause irreversible renal inadequacy. Ribichini F et al. detected 216 patients wi