碘佛醇、碘克沙醇和碘普罗胺对早期糖尿病肾病患者肾功能的影响  

Effects of Ioversol, Iodixanol, Iopromide on Renal Function in Patients with Early Diabetic Nephropathy

作　　者：王胜奇[1] 汪爱丹 WANG Shengqi;WANG Aidan(Emergency Department of Capital Medical University Xuanwu Hospital, Beijing 100045, China;Radiology Department of Capital Medical University Xuanwu Hospital, Beijing 100045, China)

机构地区：[1]首都医科大学宣武医院急诊科,北京100045 [2]首都医科大学宣武医院放射科,北京100045

出　　处：《中国药物警戒》2019年第4期199-202,共4页Chinese Journal of Pharmacovigilance

摘　　要：目的观察碘佛醇、碘克沙醇和碘普罗胺对早期糖尿病肾病患者肾功能的影响。方法将拟行强化CT检查的163例早期糖尿病肾病患者随机分为碘佛醇组、碘克沙醇组和碘普罗胺组。所有入组患者均在行强化CT检查前及检查后5、10天查血肌酐(Scr)、尿素氮(BUN)及尿微量白蛋白与肌酐比值(mAlb·Cr^(-1)),计算肾小球滤过率(eGFR),比较3组肾功能指标变化及造影剂肾病发生率。结果强化CT检查5天后3组患者SCr、BUN及mAlb·Cr^(-1)均较检查前升高(P<0.05),eGFR较检查前降低(P<0.05)。检查10天后碘佛醇组、碘普罗胺组mAlb·Cr^(-1)、eGFR仍未恢复至检查前水平;强化CT检查5天后碘克沙醇组SCr、mAlb·Cr^(-1)明显低于碘佛醇组(P<0.05),GRF明显高于碘佛醇组(P<0.05);碘普罗胺组SCr明显低于碘佛醇组(P<0.05),GRF明显高于碘佛醇组(P<0.05)。碘佛醇组造影剂肾病(CIN)发生率明显高于碘克沙醇组及碘普罗胺组(P<0.05),碘普罗胺组CIN发生率明显高于碘克沙醇组(P<0.05)。结论在早期糖尿病肾病患者中选择等渗造影剂可以减低造影剂肾病发生率。在渗透压相同的情况下,造影剂粘度越低的造影剂,造影剂肾病发生率越低。Objective To observe the effects of ioversol,iodixanol and iopromide on renal function in patients with early diabetic nephropathy.Methods 163 cases of patients with early diabetic nephropathy(DN)that prepare for enhanced CT examination were randomly divided into group ioversol group,iodixanol group and iopromide group.The blood urea nitrogen(BUN),creatinine(Scr)and urinary albumin/creatinine ratio(mAlb·Cr^-1)were checked before and 5 days,10 days after the CT scan.The glomerular filtration rates(eGFR)were calculated.The renal function indexes,incidences of contrast nephropathy were compared.Results The levels of SCr,BUN and mAlb·Cr^-1 after 5 days of enhanced CT examination were higher than that before the examination in the 3 groups(P<0.05).The eGFR was lower than that before the examination(P<0.05).The mAlb·Cr^-1,eGFR of ioversol group and iopromide group after 10 days of enhanced CT examination did not recover the levels before the examination.The SCr and mAlb·Cr^-1 of iodixanol group were significantly lower than that of ioversol group 5 days after CT examination(P<0.05).The eGRF was significantly higher than that of ioversol group(P<0.05).The SCr of iopromide group was significantly lower than that of ioversol group(P<0.05).The eGRF was significantly higher in ioversol group(P<0.05).The incidence of CIN was significantly higher in ioversol group than in iodixanol and iopromide group(P<0.05).The incidence of CIN was significantly higher in iopromide group than in iodixanol group(P<0.05).Conclusion Low-osmolality iodinated contrast media can reduce the incidence of CIN in patients with early DN.If the osmolality is similar,as the viscosity of the contrast media increases,the incidence of contrast nephropathy increases.

关 键 词：造影剂肾病 糖尿病肾病 碘佛醇 碘克沙醇 碘普罗胺 

分 类 号：R981[医药卫生—药品]