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目的观察行冠状动脉造影时造影剂对早期糖尿病肾病患者肾功能的影响。方法拟诊冠心病行冠状动脉造影检查的早期糖尿病肾病患者(24h白蛋白总量30～300mg,血肌酐正常130例,比较造影前、造影后第1,3天血尿素氮、肌酐、半胱氨酸蛋白酶抑制剂C(cystatin C,Cys C)、尿微量白蛋白(microalbumin,mAlb)和尿β2-微球蛋白(β2-microglobulin,β2-MG)水平,并观察造影剂肾病发生情况。结果患者均未发生造影剂肾病;造影后第1,3天血尿素氮、肌酐和尿β2-MG水平与造影前比较差异无统计学意义(P>0.05);造影后第1天血Cys C与尿mAlb均高于造影前(P<0.05),且超过正常值高值;造影后第3天血Cys C与尿mAlb均较造影后第1天下降(P<0.05),与造影前比较差异无统计学意义(P>0.05)。结论早期糖尿病肾病患者应用非离子型低渗性造影剂行冠状动脉造影检查可出现一过性血Cys C和mAlb水平增高。
Objective To observe the effects of contrast medium on renal function in patients with early stage diabetic nephropathy when coronary angiography is performed. Methods Patients with early diabetic nephropathy who underwent coronary angiography were enrolled in this study. The total albumin content was 30 to 300 mg for 24h and 130 for normal serum creatinine. Before bloodography, the levels of blood urea nitrogen, creatinine, Cystatin C (Cys C), microalbumin (mAlb) and β2-microglobulin (β2-MG) levels were measured and the incidence of contrast nephropathy was observed.Results Nephropathy did not occur in all patients. There was no significant difference in blood urea nitrogen, creatinine and urinary β2-MG levels between the first and third day after angiography (P> 0.05) Urinary mAlb was higher than that before angiography (P <0.05) and higher than normal values. On the 3rd day after angiography, blood Cys C and urine mAlb were decreased on the first day after angiography (P <0.05) No statistical significance (P> 0.05) .Conclusion Patients with early diabetic nephropathy using non-ionic hypotonic contrast agent in coronary angiography may appear transient blood Cys C and mAlb levels increased.