摘要
目的:研究短期内两次注射CT和MR对比剂增强扫描对肾功能的影响。方法:回顾性收集2020年1月-2022年5月在本院行CT和MR增强扫描的住院病例,检查时间在两周以内。另收集同期在本院行单独CT或单独MR增强检查的住院病例。采集住院病例资料中的临床信息、增强扫描信息和注射对比剂前后的肾功能信息,包括:性别、年龄、基础疾病、增强检查方式、增强检查时间、增强前1周以内的基础血肌酐值、增强后48~72小时的血肌酐值等。根据基础血肌酐与增强后48~72小时血肌酐的变化,将患者分为急性对比剂肾损害(CI-AKI)组和non-CI-AKI组。计算CI-AKI的发生率,并比较CI-AKI组与non-CI-AKI组之间临床信息、增强扫描信息的差异。以临床信息、增强扫描信息和注射对比剂前的肾功能信息作为自变量,拟合多因素logistic回归模型,研究CI-AKI的影响因素。结果:共收集649位患者的信息,包括:212位患者行单次CT增强检查;165位患者行单次MR增强检查;272位患者在两周之内行CT和MR共两次增强检查,两次增强检查中位间隔时间为45.8(21.4,96.6)小时。649例患者中有15例发生CI-AKI,发生率为5.5%(95%CI:0.032~0.091)。在CI-AKI组和non-CI-AKI组,患者的年龄、性别、身高、体重、基础疾病史、基础肾功能的差异均无统计学意义(P<0.05)。单次增强、短期内两次增强者CI-AKI发生率的差异无统计学意义(P>0.05)。多因素logistic回归分析显示糖尿病、高血压和基础血肌酐值是CI-AKI的影响因素(P<0.05)。短期内行两次CT和MR增强与单次增强相比,不增加CI-AKI的风险。结论:高血压和基础血肌酐值是发生CI-AKI的影响因素,而短期内行CT和MR增强与单次增强相比不增加CI-AKI的发生。
Objective:To investigate the effect on renal function of two short-term consecutive injections of contrast media for CT and MR scans.Methods:A retrospective collection was conducted on inpatient cases who underwent contrast-enhanced CT and MR scans in our hospital from January 2020 to May 2022,with the two examinations performed within a two-week interval.In addition,inpatient patients who underwent one CT or MR enhanced scan during the same period were also included.Clinical information,contrast-enhanced scan details,and renal function information before and after contrast injection were collected,including sex,age,primary diseases,type of contrast-enhanced examination,timing of the examination,baseline serum creatinine level within one week before enhancement,and serum creatinine level 48~72 hours after enhancement.Patients were divided into a contrast-induced acute kidney injury(CI-AKI) group and a non-CI-AKI group based on the changes in serum creatinine level from baseline to 48~72 hours after contrast injection.The incidence of CI-AKI was calculated,and the differences in clinical information and contrast-enhanced scan details between the CI-AKI group and the non-CI-AKI group were compared.A multivariable logistic regression model was fitted using clinical information,contrast-enhanced scan details,and pre-contrast renal function information as independent variables to investigate the factors influencing CI-AKI.Results:A total of 649 patients' information was collected,including 212 patients who underwent a single CT contrast-enhanced scan,165 patients who underwent a single MR contrast-enhanced scan,and 272 patients who underwent both CT and MR contrast-enhanced examinations within two weeks,with a median interval of 45.8(21.4,96.6) hours.Among the 649 patients,15 developed CI-AKI,with an incidence rate of 5.5%(95% CI:0.032,0.091).There were no statistically significant differences in age,sex,height,weight,primary disease history,or baseline renal function between the CI-AKI group and the non-CI-AKI group(
作者
张保翠
王可欣
杨雪
孙艳
马帅
罗健
邱建星
ZHANG Bao-cui;WANG Ke-xin;YANG Xue(Department of Radiology,Peking University First Hospital,Beijing 100034,China)
出处
《放射学实践》
CSCD
北大核心
2024年第7期947-953,共7页
Radiologic Practice
关键词
急性对比剂肾损害
对比增强
体层摄影术
X线计算机
磁共振成像
Contrast-induced acute kidney injury
Contrast enhancement
Tomography,X-ray Computed
Magnetic resonance imaging
