血液透析合并冠心病患者球囊扩张及支架治疗的可行性及疗效

本回顾分析了解放军总医院304临床部2000—2003年采用经皮球囊扩张及支架术治疗的4例慢性透析合并冠心病患的临床资料，以探讨经皮球囊扩张及支架术治疗慢性透析患冠心病的可行性及疗效。     

氧化反应对糖尿病大鼠造影剂肾病发生的影响

目的 :探讨氧化反应对糖尿病大鼠造影剂肾病发生的影响。方法 :建立SD大鼠糖尿病动物模型 ,8w后分 3组 :正常对照组 (SD组 )、糖尿病对照组 (DM组 )和糖尿病 +造影剂组 (CM组 )。其中CM组大鼠经尾静脉一次性注入 76%泛影葡胺 ( 10ml/kg体重 ,3gI(iodine) /10ml) ,DM组注射等量生理盐水。 3d后收集血标本检测血肌酐、血尿素氮 ;取肾脏组织 ,测定肾组织丙二醛 (MDA)与超氧化物歧化酶 (SOD)的含量。结果 :与正常对照组相比 ,糖尿病组 (DM组 )的MDA含量与SOD活性均明显升高 (P <0 .0 5 ) ;糖尿病大鼠注射造影剂 (CM组 ) 3d后MDA含量明显增加 ,SOD活性明显降低 ,与DM组差异有显著性 (P <0 .0 5 )。结论 :糖尿病大鼠造影剂肾病发生时 ,肾脏组织产生过氧化物增多、清除能力下降 ,提示氧化反应对糖尿病造影剂肾病的发生起一定作用     

阿托伐他汀改善对比剂对肾功能的短期影响

Objective To study the effects of atorvastatin on contrast induced renal function change and plasma hsCRP in patients undergoing coronary angiography. Methods 120 patients who underwent coronary angiography were randomized to receive atorvastatin (20 mg/qn, n = 60) or no atorvastatin (n =60) treatment 2 to 3 days before coronary angiography. Urinary α1-MG, TRF and mALB were checked for evidence of tubular or glomendar damage at start, 1 day and 2 days after the administration of a radiocontrast agent. Serum creatinine, BUN, cystatin C and hsCRP levels were also assessed at the same time. Ccr and GFR were calculated according to Cockcroft-Ganh and GFR(ml/min) = 74. 835/Cys C1.333formulas basing on serum creatinine or cystatin C concentration. Results (1) In control group, comparison with the value before coronary angiography,urinary α1-MG, TRF and mALB or serum cystatin C and hsCRP significantly increased at day 1 after angiography (P ＜ 0.01). In comparison to the levels at day 1 after angiography, urinary α1-MG, TRF, mALB, serum cystatin C significantly decreased at day 2 after angiography(P ＜ 0.01), but α1-MG, cystatin C still exceeded the values before coronary angiography, TRF and mALB levels at day 2 after angiography had no significant change compared to baseline(P ＞0.05), hsCRP LeveL at day 2 after angiography had no significant change compared to that at day 1 after angiography (P ＞ 0.05) too. (2) In comparison with the value before coronary angiography in atorvastatin-treated group, the levels of urinary α1-MG, TRF and mALB or serum cystatin C at day 1 and day 2 after angiography had no significant change compared to baseline(P ＞0.05). Serum hsCRP significantly increased at day 1 after angiography compared to baseline(P ＜ 0.01), but it had no significant change compared to day 2 after angiography (P ＞ 0.05). (3)To compare to the atorvastatin-treated group, the values of urinary α1-MG, TRF and mALB or Cys C and hsCRP significantly increased at day 1 after angiography in control group (P ＜ 0.01), the values of urinary α1 -MG, cystatin C and hsCRP still significantly increased at day 2 (P ＜ 0.01) too, but those of TRF and mALB had no significantly change at day 1 or day 2 after angiography between the two groups (P ＞ 0.05). There was no significant change in BUN, Cr, Ccr levels before and after angiography between the two groups. Conclusions Low dose contrast induces light renal function damage. Pretreatment with atorvastatin 20 mg/qn for 2 to 3 days could significantly reduce procedural inflammatory reaction, attenuate urinary protein and the effect of degrading GFR in coronary angiography patients.     

实时超声造影在肝脏疾病诊断中的应用

近年来，随着超声造影技术的发展和新型超声造影剂的面市，超声造影在肝脏疾病诊断中得到较广泛的应用，并取得了长足的进步。[第一段]     

CT增强检查的护理

在CT检查中，如发现下列情况：（1）未见异常，但不能排除临床怀疑；（2）有可疑现象，但显示不够清楚；（3）有异常征象，但不能确定其性质，为明确诊断，患者需要加做增强扫描检查（即静脉注射造影剂扫描）。增强检查前，首先要掌握好造影剂检查禁忌证和适应证及造影剂不良反应的处理。护土除要有熟练的血管穿刺技术外，还要有发现造影剂副反应的先兆和急救知识的能力。下面笔者重点介绍增强扫描中不良反应的处理与预防，并联系工作中遇到的两个相关病例的护理，进行分析。     

高渗与低渗造影剂对原有肾损害大鼠肾毒性的研究

研究高、低渗造影剂对甘油肾损害大鼠肾毒性及氨氯地平的保护作用。结果表明：高渗造影剂组血清尿素氮和血清肌酐、肾组织磷脂酶Ａ２，脂质过氧化物含量，肾小管损害积分均明显高于低渗造影剂组及甘油对照组。氨氯地平预防组肾损害明显轻于高渗造影剂组。提示低渗造影剂肾毒性较小，氨氯地平对泛影葡胺肾毒性有保护作用。     

新型磁共振造影剂研究动态

本综述新型磁共振造影剂近年来的研究进展，重点讨论了低渗性钆螯合物，肝胆造影剂，超顺磁性氧化灶，病灶靶向性造影剂，血池造影剂，脂质体包裹的造影剂及磁共振胃肠造影剂等的研究现状，并分析了各种造影剂的磁共振造影特性。     

利用最佳间歇式二次谐波显像非损伤性评价心肌血流注

本研究的目的是确定心肌声学造影间歇性二次谐波显像的最佳歇周期的范围。在１５只开胸犬中，分两个阶段进行了采用不同间歇周期显像的多次注射，观察了心肌显影的不同效果，结果发现在间歇３个心动周期时声学强度的峰值最大，３－５个心动周期时显影的持续时间较长，并且图像信息量较多，结论：心肌声学造影间歇性二次谐波显最佳间歇周期的范围是３－５心动周期。     

山楂胃石的X线诊断及治疗（附4例报告）

1临床资料本组4例患者，其中男2例，女2例，年龄35～62岁。食山楂数量4个到10多个，食山楂到透视时间4天到1个月。临床症状均为胃痛、恶心呕吐、反酸，1例有慢性肥厚性胃炎。其中3例经口服气钡双重造影剂(发泡剂)，2～3天胃石排出；1例术前误诊为胃癌准备手术。X线检查：4例均在胃窦部见鸡卵大至鹅卵大充盈缺损，边缘不光整，密度不均，     

造影剂肾病的危险因素及防治进展

随着造影剂在诊断和介入诊治术中的广泛应用，造影剂肾病（CIN）已成为当前医院内发生急性肾功能衰竭的第3位常见原因。了解CIN发病的危险因素及防治有助于识别高危患者、采取正确的预防措施、及时诊断和治疗，降低发病率及死亡率。