脑数字减影血管造影术后患者血液和肾功能的变化

Juan Manuel Marquez-Romero , Marco Zenteno , Antonio Arauz
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摘要

目的描述一组接受选择性脑数字减影血管造影术(DSA)的患者中造影剂诱导的急性肾损伤(CI-AKI)的发生率和红细胞压积的变化,接受脑DSA的患者在手术前评估红细胞压积水平和CI-AKI风险因素,并在暴露于造影剂72小时后评估CI-AKI。结果215例患者中男性109例,平均年龄36.6岁。最常见的CI-AKI危险因素是高血压。14天后无永久性肾功能损害病例。红细胞压积(45.7±4.9,vs.44.5±4.6,p=0.001)、估计肌酐清除率(129.7±48.3,vs.123.1±40.5,p=0.002)发生显著变化,血清肌酸酐(0.72±0.19,vs 0.74±0.18,p=0.031)。对比剂给药后72小时血清肌酸酐的平均变化为+0.27±0.10 mg/dL(p<0.05)。结论选择性脑DSA后CI-AKI的发生率为1.4%。术后72小时血细胞比容显著下降。
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Changes in blood and renal function in patients after cerebral digital subtraction angiography

Objective

Describe the incidence of contrast-induced acute renal injury (CI-AKI) and the changes in hematocrit in a cohort of patients undergoing elective cerebral digital subtraction angiography (DSA).

Methods

In this prospective study, patients undergoing cerebral DSA were assessed for hematocrit level and CI-AKI risk factors before the procedure and for developing CI-AKI 72 h after exposure to the contrast media.

Results

Among 215 patients (109 men, mean age 36.6 years). The most frequently found CI-AKI risk factor was hypertension. There were no cases of permanent renal impairment after 14 days. Significant changes were observed in hematocrit (45.7 ± 4.9, vs. 44.5 ± 4.6, p = 0.001), estimated creatinine clearance (129.7 ± 48.3, vs. 123.1 ± 40.5, p = 0.002), and serum creatinine (0.72 ± 0.19, vs 0.74 ± 0.18, p = 0.031). The mean change in serum creatinine 72 h after contrast administration was +0.27 ± 0.10 mg/dL (p < 0.05).

Conclusions

The incidence of CI-AKI after elective cerebral DSA was 1.4%. A significant decrease in hematocrit was observed up to 72 h after the procedure.

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