呋塞米与对比剂肾病的研究进展

Research progress on correlation of furosemide with contrast-induced nephropathy

随着影像学及介入诊疗的快速发展,对比剂的使用在临床上越来越普遍,对比剂肾病(contrast-induced nephropathy,CIN)作为对比剂使用中最常见的并发症,可增加患者血液透析、死亡风险,且延长住院时间、增加医疗费用,使患者生活质量、生命健康受到显著影响,然而目前CIN尚无有效的治疗手段。水化作为CIN预防策略中目前循证最多、最为有效方式,一直是广泛应用于临床。然而在慢性肾脏病、充血性心力衰竭等CIN高危患者中,水化不当反而容易加重心肾功能损害,因此如何达到“充分”而又避免“过度”至关重要。呋塞米作为心肾功能不全患者常用的药物,对CIN的作用报道不一。本文将对CIN进行简单概述并对呋塞米与CIN的相关研究进展做一综述。

With rapid development of radiology and intervention diagnosis and treatment,use of contrasts is becoming more and more common.Contrast-induced nephropathy (CIN) has become one of the most common complications which increases the risk for mortality of dialysis,prolongs hospitalization,and raises medical cost,so as to influence life quality and health of patients greatly.However,there is no effective treatment approach for CIN.Only hydration has so far been the most evidence-based and the most effective way among CIN preventive strategies,and has been widely used in clinical practice.However,in patients at high risk for CIN with chronic kidney disease and congestive heart failure,inappropriate hydration may aggravate the damage of heart and kidney functions.Therefore,how to achieve "sufficiency" and avoid "excessiveness" is crucial.Furosemide is a widely used drug in patients with heart and kidney insufficiency,whether it increase or decrease the risk for CIN is unknown.This article is purposed to provide a brief outline of CIN and a review of research progress on correlation of furosemide with CIN.