中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (10): 842-848.doi: 10.3969/j.issn.1671-4091.2025.10.011

• 综述 • 上一篇    下一篇

动脉注射与静脉注射造影剂对造影剂诱导的急性肾损伤发生率及短期预后影响的Meta分析

常敏南    黄轲欣    黄心怡    吴昊宇    马子明    王 顺    买尔孜亚·吾斯曼   

  1. 830054 乌鲁木齐，1新疆医科大学第一附属医院肾病中心
  • 收稿日期:2024-12-02 修回日期:2025-07-29 出版日期:2025-10-12 发布日期:2025-10-12
  • 通讯作者: 王顺 E-mail:wangshun128@126.com
  • 基金资助:
    新疆维吾尔自治区重大科技专项项目(2022A03001-2)；新疆医科大学大学生创新训练计划项目(X202310760115)；天山英才医药卫生高层次人才培养计划项目(TSYC202301B012)

A meta-analysis of intra-arterial and intravenous injection of contrast agents on the incidence and short-term prognosis of contrast-induced acute kidney injury

CHANG Min-nan, HUANG Ke-xin, HUANG Xin-yi, WU Hao-yu, MA Zi-ming, WANG Shun, MAIERZIYA · wusiman   

  1. Center of Nephropathy, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
  • Received:2024-12-02 Revised:2025-07-29 Online:2025-10-12 Published:2025-10-12
  • Contact: 830054 乌鲁木齐，1新疆医科大学第一附属医院肾病中心 E-mail:wangshun128@126.com

摘要： 目的  通过Meta分析探讨动脉和静脉注射造影剂对造影剂诱导的急性肾损伤(contrast-induced acute kidney injury,CI-AKI)发生率及短期预后的影响。 方法 在PubMed、Cochrane Library、中国知网(CNKI)、万方数据库(WanFang)、维普数据库(VIP)等数据库中全面检索文献，采用RevMan5.4软件进行Meta分析。 结果  据纳入和排除标准最终纳入7篇文献。动脉造影组CI-AKI的总发生率(OR=1.222，95% CI：1.040～1.435，P=0.010)、基线估算肾小球滤过率(estimate glomerular filtration rate,eGFR)≥60 ml/min患者的CI-AKI发生率(OR=1.400，95% CI：1.061～1.848，P=0.020)高于静脉造影组；静脉造影组患者的全因死亡率高于动脉造影组(OR=0.471，95% CI：0.254～0.872，P=0.020)；静脉造影组人均年龄大于动脉造影组(MD=-1.139，95% CI：-1.611～-0.668，P＜0.001)。 结论  动脉注射造影剂后发生CI-AKI的风险较静脉更高，但静脉造影组患者的预后较动脉造影组差。造影途径是CI-AKI发生的危险因素之一，提示临床关注造影途径对CI-AKI发生率及患者预后的影响，早期进行个体化干预，延缓疾病进展。

关键词: 造影剂肾病, 急性肾损伤, 动脉注射, 静脉注射

Abstract: Objective  A meta-analysis was conducted to explore the impact of intra-arterial and intravenous injection of contrast agents on the incidence of contrast-induced acute kidney injury (CI-AKI) and its short-term prognosis.  Methods  A comprehensive literature search was conducted in databases such as PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Database, and VIP Database. Meta-analysis was performed using RevMan5.4 software.  Results  According to the inclusion and exclusion criteria, a total of 7 articles were finally included. The total incidence of CI-AKI (OR=1.222, 95% CI: 1.040～1.435, P=0.010) and the incidence of CI-AKI in patients with baseline estimated glomerular filtration rate (eGFR) ≥60 ml/min (OR=1.400, 95% CI: 1.061～1.848, P=0.020) were higher in the intra-arterial angiography group than those in the intravenous angiography group. The all-cause mortality rate was higher in the intravenous angiography group than that in the intra-arterial angiography group (OR=0.471, 95% CI: 0.254～0.872, P=0.020). The average age of the patients was older in the intravenous angiography group than that in the intra-arterial angiography group (MD=-1.139, 95% CI: -1.611～-0.668, P<0.001).  Conclusions  The risk of CI-AKI after intra-arterial injection of contrast agents is higher than that after intravenous injection, but the prognosis of patients is worse in the intravenous angiography group than in the intra-arterial angiography group. The angiography route is one of the risk factors for CI-AKI, suggesting that clinicians should pay attention to the impact of angiography route on the incidence of CI-AKI and the prognosis of patients, and carry out individualized interventions as early as possible to delay the progression of CI-AKI.

Key words: Contrast-induced nephropathy, Acute renal failure, Intra-arterial, Intravenous

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