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INTENS CARE MED：含碘造影剂不增加危重患者的急性肾损伤发生率

2017-07-31 安雅晶 环球医学资讯

含碘造影剂危重患者急性肾损伤发生率
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通常认为危重患者对碘对比剂的肾毒性伤害比较敏感。2017年6月，发表在《Intensive Care Med》上的一项荟萃分析结果不支含碘对比剂会显着增加危重患者的急性肾损伤发生率。

通常认为危重患者对碘对比剂的肾毒性伤害比较敏感。2017年6月，发表在《Intensive Care Med》上的一项荟萃分析结果不支含碘对比剂会显着增加危重患者的急性肾损伤发生率。

目的：危重患者中常见急性肾损伤，通常认为其对碘对比剂的肾毒性伤害比较敏感。但是，考虑到缺乏有对照组的观察性研究，其导致的发生率仍不清楚。本研究基于新数据考虑了样本和作用大小并纳入了对照组，评估了危重患者中碘对比剂导致的急性肾损伤发生率。

方法：对造影剂暴露的危重患者vs匹配的未暴露患者中检测急性肾损伤发病率的研究进行系统评价。采用贝叶斯混合效应多因素逻辑回归模型开展患者水平的荟萃分析。

结果：10项研究被识别；仅4项考虑了基线急性肾损伤风险，3项进行了患者匹配（560名患者）。这3项研究（有关导致急性肾损伤风险的模糊和公平的先验假说）的客观荟萃分析未发现含碘造影剂会增加急性肾损伤发生率（比值比0.95，95%最高后验密度区间 0.45～1.62）。贝叶斯分析表明，结论支持造影剂相关的急性肾损伤发生率具有统计学意义，尽管观察缺乏相关性，一种先验性的观念有非常强烈的偏见，将既往没有对照的报告设定为纳入对照组相匹配研究的证据强度3～12倍的权重。

结论：对含碘造影剂暴露的匹配队列研究的荟萃分析，不支含碘对比剂会显着增加危重患者的急性肾损伤发生率。

原始出处：
Ehrmann S, Quartin A, Hobbs BP,et al.Contrast-associated acute kidney injury in the critically ill: systematic review and Bayesian meta-analysis.Intensive Care Med. 2017 Jun;43(6):785-794. doi: 10.1007/s00134-017-4700-9. Epub 2017 Feb 14.

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    2017-08-23 12498ebem19暂无昵称

    #TENS#

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    2018-02-16 一叶知秋

    #发生率#

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    2017-08-02 ms3046638856685384

    #损伤#

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    2017-08-02 sodoo

    #造影#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2038723, encodeId=96632038e2371, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Aug 23 17:05:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826372, encodeId=313c18263e2cf, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Fri Feb 16 02:05:00 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397279, encodeId=edda139e27984, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Wed Aug 02 03:05:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494036, encodeId=8a421494036ca, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Aug 02 03:05:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607903, encodeId=69fd160e90380, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Aug 02 03:05:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228523, encodeId=9bb52285237d, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Jul 31 17:59:22 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-08-02 ms3994565386320060

    #Med#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2038723, encodeId=96632038e2371, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Aug 23 17:05:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826372, encodeId=313c18263e2cf, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Fri Feb 16 02:05:00 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397279, encodeId=edda139e27984, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Wed Aug 02 03:05:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494036, encodeId=8a421494036ca, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Aug 02 03:05:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607903, encodeId=69fd160e90380, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Aug 02 03:05:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228523, encodeId=9bb52285237d, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Jul 31 17:59:22 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-07-31 131****1460

    学习了受益匪浅。

    0