目的:观察糖尿病患者使用造影剂后发生造影剂肾病的临床情况。方法:108例肾功能正常的患者根据血糖水平被分为3组,分别接受X线造影,观察3组发生造影剂肾病情况。结果: 血糖正常组血清肌酐造影前后无明显变化,糖尿病早期组造影后血肌酐升高,与造影前相比有统计学意义(Plt;005),糖尿病组造影后肌酐升高明显,与造影前相比具有显著统计学意义(Plt;001),且血肌酐恢复较慢,造影后第5天仍处于较高水平,与造影前相比有统计学意义(Plt;005)。结论: 糖尿病早期及糖尿病患者即使肾功能正常,使用造影剂后也容易发生造影剂肾病,对这类高危人群应尽量避免使用造影剂。
ObjectiveTo systematically review the efficacy of statins for contrast induced nephropathy (CIN) prevention in cardiac intervention surgery patients. MethodsWe electronically searched databases including PubMed, Web of Knowledge, The Cochrane Library (Issue 5, 2015), VIP, WanFang Data and CNKI to collect randomized controlled trials (RCTs) about statins for CIN prevention in cardiac intervention surgery patients from inception to May 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 25 RCTs involving 37 353 patients were included, among them, 3 794 were CIN patients. The results of meta-analysis indicated that: compared with the placebo/blank group, the incidence rate of CIN was decreased in the statins group with a significant difference (OR=0.68, 95%CI 0.63 to 0.73, P<0.000 01). ConclusionCurrent evidence shows statins can reduce incidence of CIN in cardiac intervention surgery patients. Due to limited quality and quantity of the included studies, the above conclusions need more high quality studies to verify.
Objective To discuss feasibility and effectivity of intraoperative ultrasound (US) during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. Methods A radiographic contrast nephropathy patient of abdominal aortic aneurysm and left internal iliac artery aneurysm was treated by EVAR without iodine contrast media assisted by US. Then summarized the data of this patient. Results The precise placement of the stent-graft was performed for abdominal aortic aneurysm. The left internal iliac artery aneurysm was successfully treatment with the stent-graft and coils. Intraoperative Ⅱ type endoleak from inferior mesenteric artery and Ⅰ b type endoleak from right iliac stent were identified by using US. The operative duration was 120 min and the blood loss was only 20 mL. Ⅱ type endoleak was still detected and the Ⅰ b type of endoleak was loss on postoperative a week. Conclusion Intraoperative US-assisted EVAR in patients with infrarenal abdominal aortic aneurysm represents a new option for intraoperative visualization of aortoiliac segments required as proximal or distal fixation zones and identification of endoleaks, especially in those patients with contraindications for usage of iodine-containing contrast agents.