对比剂后急性肾损伤研究进展

Research progress in Postcontrast Acute Kidney Injury

对比剂后急性肾损伤(PCAKI),又称为对比剂肾病(CIN),是指使用碘对比剂后发生的急性肾功能损害,其发病机制主要包括对比剂的直接肾毒性作用、缺血缺氧、氧化应激、免疫炎症反应、表观遗传调控、凋亡等。识别高危患者并给予有效的预防策略是预防PCAKI的关键。PCAKI的预防策略主要包括停用非必要的肾毒性药物、合理选择对比剂类型、减少对比剂用量、以及在水化基础上联合药物治疗等,此外,中医药在预防PCAKI方面也有一定潜力。

Postcontrast acute kidney injury(PCAKI),formerly known as contrast medium nephropathy(CIN),refers to acute renal impairment after the use of iodine contrast media.The pathogenesis mainly includes direct nephrotoxicity of contrast agents,ischemia and hypoxia,oxidative stress,immune inflammatory response,epigenetic regulation,apoptosis,etc.The key to prevent PCAKI is to identify high-risk patients and give effective prevention strategies,which mainly include discontinuation of non-essential nephrotoxic drugs,rational selection of contrast agent types,reduction of contrast agent dosage,and combination of drug therapy based on hydration.In addition,traditional Chinese medicine also has certain potential in preventing PCAKI.