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1例65岁男性2型糖尿病患者,因反应迟钝伴口齿不清入院。头颅磁共振成像示脑梗死(急性期),给予肠溶阿司匹林(0.1g,1次/d)、依达拉奉(30mg,1次/d)及甲钴胺等药物治疗。因胸部、腹部CT增强扫描,连续2d各使用造影剂碘普罗胺100ml(含碘30g),第3天出现双下肢水肿,尿量400ml/24h,随后无尿,静脉给予呋塞米未见好转。复查血肌酐475μmol/L,尿素氮24.5mmol/L。诊断为急性肾衰竭,考虑与碘普罗胺有关。连续血液透析治疗5d后,患者尿量增加,血肌酐降至284μmol/L。17d后血肌酐231μmol/L,尿素氮14.4mmol/L。患者双下肢水肿明显好转,出院。
A 65-year-old male with type 2 diabetes mellitus admitted to hospital due to unresponsiveness. Head magnetic resonance imaging showed cerebral infarction (acute phase), given enteric-coated aspirin (0.1g, 1 / d), edaravone (30mg, 1 / d) and mecobalamin and other drugs. Due to the chest and abdomen enhanced CT scan, the contrast agent iopromide 100ml (containing 30g iodine) was used for 2 consecutive days and the edema of both lower extremities appeared on the 3rd day. The urinary output was 400ml / 24h, and no urine or intravenous furosemide was found . Review serum creatinine 475μmol / L, urea nitrogen 24.5mmol / L. Diagnosis of acute renal failure, consider and iopromide related. After continuous hemodialysis treatment 5d, the patient’s urine output increased, serum creatinine dropped to 284μmol / L. After 17 days serum creatinine 231μmol / L, urea nitrogen 14.4mmol / L. Patients with lower extremity edema significantly improved, discharged.