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目的观察应用二甲双胍的2型糖尿病患者(T2DM)水化疗法对肾功能的影响。方法选取放射科行碘造影检查的2型糖尿病患者60例,根据造影前是否应用二甲双胍,分为二甲双胍组(n=30)和非二甲双胍组(n=30)。采用水化疗法,所有患者造影后6h内在日常饮水量基础上多饮水1 000mL。检测造影前,造影后第3、7、30天肌酐(C r)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、尿酸(UA)等指标的变化,计算肾小球滤过率(GFR)。结果二甲双胍组造影剂肾病发生率3.33%(1/30),非二甲双胍组为6.67%(2/30)。两组造影前后C r、GFR和差值变化程度的差异均无统计学意义(P>0.05)。造影后3d,二甲双胍组TC、LDL及非二甲双胍组TC较造影前下降(P<0.05)。造影后7d,二甲双胍组UA、LDL较造影前下降(P<0.05)。结论对于未合并严重肾功能不全的2型糖尿病患者,在水化疗法及严密监测肾功能的基础上,造影前应用二甲双胍是相对安全的。
Objective To investigate the effect of methotrexate on type 2 diabetes mellitus (T2DM) on renal function. Methods 60 patients with type 2 diabetes mellitus who underwent iodine contrast radiography were divided into metformin group (n = 30) and non-metformin group (n = 30) according to whether metformin was used before angiography. Using hydration therapy, all patients within 6h after radiotherapy on the basis of daily drinking water more than 1 000mL. The levels of creatinine (C r), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), uric acid UA) and other indicators of change, calculate glomerular filtration rate (GFR). Results The incidence of nephropathy in metformin group was 3.33% (1/30) and in non-metformin group was 6.67% (2/30). Before and after angiography C r, GFR and the difference in the degree of difference was not statistically significant (P> 0.05). The levels of TC, LDL and metformin in metformin group were lower than those before angiography (P <0.05) 3d after angiography. At 7 days after angiography, the levels of UA and LDL in metformin group were lower than those before angiography (P <0.05). Conclusions For patients with type 2 diabetes who do not have severe renal insufficiency, the use of metformin prior to angiography is relatively safe, based on hydration therapy and careful monitoring of renal function.