二甲双胍对2型糖尿病病人造影剂肾病的影响

目的观察2型糖尿病(T2DM)病人接受造影前服用二甲双胍对肾功能的影响。方法回顾心内科行造影检查的T2DM病人,根据造影前是否应用二甲双胍,分为二甲双胍组和非二甲双胍组。所有病人造影前及造影后3 d、1年检测肾功能及尿酸等的变化。结果两组造影剂肾病发生率比较差异无显著性(P>0.05)。两组内、组间血肌酐、肾小球率过率(GFR)造影前后比较差异无显著性(P>0.05)。当造影前GFR介于30~90 mL/min时,二甲双胍组造影后3 d的GFR明显下降(t=2.485,P<0.05)。结论未合并严重肾衰竭及造影前因急症不能停用二甲双胍的T2DM病人造影是相对安全的。

THE EFFECTS OF METFORMIN ON CONTRAST MEDIA NEPHROPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective To evaluate the influence of metformin on renal function in patients with Type 2 diabetes mellitus(T2DM) before angiography. Methods A retrospective review was done for 100 T2DM patients underwent angiography in Department of cardiology.They were equally divided into metformin group and non-metformin group based on whether or not using metformin before angiography.The renal function and uric acid were measured before,and three days and one year after angiography. Results The difference of the incidence of contrast-induced nephropathy between the two groups was not significant(P>0.05).The levels of serum creatinine and glomerular filtration rate(GFR) had no significant changes within each group before and after angiography,and between the two groups as well.When GFR ranged 30-90 mL·min-1,GFR significantly declined in metformin group three days after angiography(t=2.485,P<0.05). Conclusion For T2DM patients without complicating renal failure,or those do not discontinue metformin due to emergency,angiography is relatively safe.