| 比较等渗与低渗碘对比剂的肾毒性：随机对照试验的Meta分析 |
| Alternative Title | The relative renal safety of iso-osmolar contrast media compared with low-osmolar contrast media:Meta-analysis of randomized controlled trials
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| 张沥 |
| Thesis Advisor | 雷军强
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| 2014-05-27
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 对比剂肾病
碘克沙醇
低渗对比剂
RCT
Meta分析
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| Abstract | 目的：本研究旨在对照观察等渗对比剂碘克沙醇与低渗碘对比剂(LOCM)的肾毒性。
方法：计算机检索相关数据库及网络资源，纳入使用碘克沙醇或LOCM进行对照观察CIN发病率的随机对照试验(RCT)。使用GRADE PRO 3.6软件进行证据质量等级分析和制图，使用Revman 5.2软件进行Meta分析。发表偏倚采用Stata 12.0软件绘制漏斗图。
结果：最终纳入44个随机对照试验，共8931名患者，本研究结果总体倾向于碘克沙醇，碘克沙醇组发病危险相对低于LOCM组且具有统计学意义（RR:1.27,95% CI:1.08-1.50；P=0.004）。亚组分析结果示：根据对比剂注射途径不同，显示动脉内给药时，碘克沙醇相对危险度低于LOCM组（RR：1.41，95% CI：1.16-1.73；P= 0.0007）。但静脉内给药时，碘克沙醇与LOCM组无统计学差异（RR：0.81，95% CI：0.48-1.36；P= 0.42）。根据对比剂使用原因，通过冠脉造影或冠脉介入检查（Percutaneous Coronary Intervention，PCI）方式进行对比剂检查，碘克沙醇组相对危险低于LOCM组，（RR：1.45，95% CI：1.10-1.92；P=0.009）。通过CT检查（RR：0.78，95% CI：0.46-1.34；P=0.37）、静脉肾盂造影（RR：1.00，95% CI：0.15-6.85；P=1.00）则均无统计学差异。
结论：本项Meta分析结果表明，总体上应用碘克沙醇后CIN发病率低于LOCM组。通过冠脉造影或PCI方式进行对比剂检查，碘克沙醇组相对危险低于LOCM组。经过静脉内给药时，应用碘克沙醇的相对危险度并不低于LOCM组 |
| Other Abstract | Objective: This study aimed to control renal toxicity between iso-osmolar contrast media and low-osmolar contrast media(LOCM).
Methods: We searched through computer relevant databases and network resources by from building a database retrieval time period to January, 2014, and manually retrieve related magazines. Included the use of iodixanol or LOCM controlled study conducted CIN incidence randomized controlled trials (RCT). Using GRADE PRO 3.6 software of quality classification. Using Revman 5.2 Meta-analysis software.
Results: Eventually our study included 44 randomized controlled trials involving 8931 patients, the overall results of the study tended to iodixanol, iodixanol group the risk is relatively lower than LOCM group and was statistically significant (RR: 1.27, 95% CI: 1.08-1.50; P=0.004).Subgroup analysis results are shown: According to the contrast agent injection route showed intra-arterial administration of iodixanol relative risk of less than LOCM group (RR: 1.41,95% CI: 1.16-1.73; P=0.0007). However, intravenous administration of iodixanol and LOCM was no statistically significant difference (RR: 0.81,95%CI: 0.48-1.36; P=0.42).According to the reason for the use of contrast agents, contrast agents checked by coronary angiography or Percutaneous Coronary Intervention(PCI), Meta analysis results indicated that the relative risk of iodixanol group less than LOCM group(RR: 1.45,95%CI:1.10-1.92; P=0.009). Through CT examination (RR: 0.78,95% CI: 0.46 -1.34; P=0.37),intravenous urography (RR:1.00,95%CI:0.15-6.85; P=1.00) were not statistically different.
Conclusion: The Meta analysis showed that, on the whole, CIN incidence application iodixanol be lower than LOCM. By coronary angiography or PCI, the relative risk of iodixanol group below LOCM group.But after intravenous administration,the relative risk of application of iodixanol group was not lower than LOCM. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223811
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
张沥. 比较等渗与低渗碘对比剂的肾毒性：随机对照试验的Meta分析[D]. 兰州. 兰州大学,2014.
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