-
..
. .. -
-
- () . . , ,
-
,
+ > 70 IV () (
-
- : 1,2% 11,2% 1 30% 2 50% + 1. Rich et al. Arch Intern Med;
1990; 2. Manske et al. Am. J. Med; 1990; 3. Aspelin et al. NEJM;
2003
- Mehran et al. JACC 2004;44:1393-1399. >75 . - 5554331 100 3
> 1.5mg/dl4eGFR
-
, , , (5 , 17 ) .
: 3 ., 129 ( = 1.5-3.5 /)-, N=64 = 163 ml 17%
-, N=65 = 162 ml 25%
Aspelin P et al, NEJM, 2003; 348: 491-499
-
7 010020030040050060070080001234567 SCr (/)
010020030040050060070080001234567SCr (/)
-
- ( > 0,5 /) 3 Aspelin et al. New Engl J Med 2003; 348:
4914993,1 %26,2 %051015202530 0,5 / ( 44,2 /)015,4 %051015202530P =
0,002 (%) (%) 1,0 / ( 88,4 /)
-
- - - , - - .
-
Jo S-H et al. J Am Coll Cardiol. 2006;48:924-930.P = 0,023eGRF
< 30 / 140 < 40 %P = 0,041P = 0,038P =
0,01412,510,49,85,253,326,521,3150204060 (%) -
-
- , -
-
: ( 0,5 / 25 % 3 ) : - (MACE) 30-
-
-
( SCr 0.5 / 25% 3- ):% patientsp=0.011Nie et al. Cath Cardio
Interv 2008.
-
- (MACE), . .
-
(%) COURT (2000.) (p=0.0027)5.49.5 ()VICC (2003.)
(p=0.003)4.89.0 ()
Nie Bin (2008.) (p=0.025)1.98.8 ()
-
1,15+0,321,20+0,12=0,461,39+0,401,30+0,17=0,0061,42+0,411,33+0,19=0,016p
- 1,28+0,131,21+0,06=0,461,68+0,111,34+0,11p
-
N , , , , 1 - ????
-
, ( 100 , , 4 24 ) - 24 , Thomsen HS, Morcos SK. Review
article.Contrast media and the kidney: European Society of
Urogenital Radiology (ESUR) Guidelines BJR 2003; 76:513518
-
King SB et al. Circulation. 2008;117:1-35; Anderson JL et al. J
Am Coll Cardiol. 2007;50:e1-e157 IA
, , .
-
, ( 100 , , 4 24 ) - 24 , Thomsen HS, Morcos SK. Review
article.Contrast media and the kidney: European Society of
Urogenital Radiology (ESUR) Guidelines BJR 2003; 76:513518
-
(%) COURT (2000.) (p=0.0027)5.49.5 ()VICC (2003.)
(p=0.003)4.89.0 ()
Nie Bin (2008.) (p=0.025)1.98.8 ()
-
-
*There is a strong bidirectional association between cardiac
diseases and renal insufficiency. *Risk factors for CIN maybe
divided into patient-related and procedure-related. Patient-related
factors includeRenal insufficiencyDiabetes mellitus with renal
insufficiencyAgeVolume depletionHypotensionLow cardiac outputClass
IV CHFOther nephrotoxinsRenal transplantHypoalbuminemia (
