血肌酐正常人群中糖尿病与对比剂肾病的相关性研究  

A study on the correlation between diabetes mellitus and contrast-induced nephropathy in patient population with normal serum creatinine level

作　　者：叶锦棠[1] 张保翠[1] 罗健[1] 王蕊[1] 王霄英[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034

出　　处：《放射学实践》2016年第2期123-125,共3页Radiologic Practice

摘　　要：目的:探讨行CT增强扫描时,血清肌酐(Scr)正常人群中糖尿病与对比剂肾病(CIN)的相关性。方法:回顾性收集2011年10月-2012年4月在本院行CT增强扫描的Scr正常人群,共1163例患者入组,其中男632例,女531例。记录患者是否合并糖尿病、高血压、冠心病、肿瘤等病史情况,使用肾脏疾病饮食改良(MDRD)公式计算肾小球滤过率(eGFR)。记录患者在CT增强扫描前2周内及检查后48~72h内的Scr值,以判断是否发生CIN。应用logistic多因素回归分析探讨糖尿病是否为CIN的独立危险因素。结果:1163例Scr正常人群中,糖尿病患者182例,非糖尿病患者981例;67例eGFR<60mL/min/1.73m^2,其中6例eGFR<45mL/min/1.73m^2。CT增强扫描后48~72h,共检出CIN101例(糖尿病患者中16例,非糖尿病患者中85例)。Logistic回归分析认为糖尿病是CIN的一个独立危险因素(P<0.001)。结论:糖尿病是CIN的一个独立危险因素,即使是Scr正常人群,行CT增强检查时,仍应对糖尿病患者给予重点观察和监测。Objective.. To investigate the correlation between diabetes mellitus and contrast-induced nephropathy （CIN） in patient population of normal serum creatinine （Scr） level. Methods ： Data of 1163 patients undergoing contrast en- hanced CT were analyzed retrospectively. Clinical history including hypertension,coronary heart disease and cancer was re- corded. Estimated glomerular filtration rate （eGFR） was calculated following MDRD equation. CIN was recognized by com- parison of serum creatinine before and after CT scan. Logistic regression was used for analysis to explore if diabetes mellitus was an independent risk factor of CIN. Results： The history of diabetes mellitus was found in 182 patients, and the other 981 without history of diabetes mellitus. 67 of the patients were detected being eGFR〈60mL/min/1.73m2 , moreover, 6 of them were detected being eGFR〈45mL/min/1.73m2. CIN was diagnosed in 101 cases. It was proved by logistic regression that diabetes mellitus is an independent risk factor of CIN （P〈0. 001）. Conclusion： Diabetes is an independent risk factor of CIN. Diabetic patients,even with normal Scr level,should be paid more attention when undergoing contrast enhanced CT.

关 键 词：对比剂 糖尿病 对比剂肾病 血清肌酐 体层摄影术 X线计算机 

分 类 号：R587.1[医药卫生—内分泌] R814.42[医药卫生—内科学]