Crit Care:造影剂对脓毒症相关的急性肾损伤患者肾功能和预后影响

2019-07-10 xing.T MedSci原创

由此可见,单次给予造影剂与脓毒症患者AKI恶化或短期/长期死亡率增加无关。

最近的研究表明,对于肾功能相对正常的患者,造影剂引起的肾损伤潜在风险较低。然而,造影剂是否会导致急性肾损伤(AKI)患者(包括脓毒症相关AKI患者)的肾功能进一步恶化仍不清楚。近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,该研究旨在评估造影剂对已有AKI的败血症患者肾功能和死亡率的影响。

研究人员在外科重症监护室进行了倾向评分匹配的历史队列研究,纳入了被诊断败血症和AKI的成年患者,并评估了2011年至2017年期间败血症数据库的记录。入院后24小时内接受造影剂的AKI脓毒症患者(C组)与未接受造影剂(NC组)的脓毒症患者按1:1进行匹配。主要结局是肾功能恶化(DRF),其定义为血清肌酸酐水平升高(>0.3mg/dL或超过基线水平1.5倍)或开始接受肾脏替代疗法。

该研究共纳入了339名患有AKI的脓毒症患者。在倾向评分调整后,C组和NC组的DRF率相似(34.0% vs. 35.0%; P=1.00)。7天死亡率(3.0% vs. 6.0%; P=0.50)、28天死亡率(9.2% vs. 15.0%; P=0.25)和90天死亡率(25.8% vs. 32.1%; P=0.45)两组之间相当。在高风险亚组的倾向调整(入院时AKI为2期和3期)亚组中,DRF的比率在两组之间也相似。

由此可见,单次给予造影剂与脓毒症患者AKI恶化或短期/长期死亡率增加无关。

 
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    2020-01-14 yese
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    2019-07-11 sodoo
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    2019-07-10 龙胆草

    学习谢谢分享

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