极低碘对比剂指导冠心病合并慢性肾功能不全介入治疗研究进展

Research progress on ultra-low contrast-guided percutaneous coronary interventions in the treatment of coronary heart disease combined with chronic renal insuffi ciency

临床中约10%的患者在接触碘对比剂后会发生对比剂肾病,而对于既往存在肾功能不全者对比剂肾病的发生率可高达40%。严重的对比剂肾病会导致肾功能短时间内急剧恶化,从而诱发严重的不良临床事件。目前临床上已有多种策略可用于预防对比剂肾病的发生,其中减少碘对比剂的剂量是避免对比剂肾病发生的关键。基于此有学者提出了“极低碘对比剂”指导经皮冠状动脉介入治疗这一策略,旨在最大程度减少冠状动脉介入术中碘对比剂的用量。本文就该策略作一综述。

Contrast-induced nephropathy occurs in 10%~40%of patients exposed to intravascular radiographic contrast agents.It may results in a rapid decline in kidney function,which lead to serious adverse events.Various measures have been used to lessen the occurrence of contrast-induced nephropathy,and it is essential to reduce contrast volume.According to this,the strategy“ultra-low contrast”has been proposed,aiming to minimize the amount of contrast during the intervention.This article provides a review of this strategy.