2型糖尿病与老年人行冠状动脉CT血管造影术后造影剂相关性肾损伤的关系

Association between Type 2 Diabetes and Contrast-associated Renal Injury after Coronary CT Angiography in the Elderly

目的:探究2型糖尿病与老年人行冠状动脉CT血管造影术(CTA)后造影剂相关性肾损伤的关系。方法:选取2019年12月—2020年12月河南大学第一附属医院80例行冠状动脉CTA的住院患者作为研究对象,将其中40例既往无糖尿病病史命名为A组,另40例为有糖尿病病史命名为B组,并采用血肌酐(Scr)、内生肌酐清除率(Ccr)、尿素氮(BUN)等指标检测肾功能,以术后5 d内Scr升高至44.2~88.4μmol/L为肾功能损伤标准。结果:在CTA检查前将A组和B组Scr、Ccr和BUN进行对比,差异无统计学意义(t=0.263、-0.255、-1.032,P>0.05)。在行冠状动脉CTA检查后24 h的A组和B组Scr、Ccr、BUN进行对比,差异有统计学意义(t=-5.701、4.412、-3.641,P<0.05)。48 h的A组和B组的Scr、Ccr、BUN指标进行对比,差异有统计学意义(t=-5.197、3.868、-3.622,P<0.05)。72 h的A组和B组的Scr、Ccr、BUN进行对比,差异有统计学意义(t=-3.926、3.251、-3.932,P<0.05),且在冠状动脉CTA检查后A组的肾损伤发生率显著低于B组,差异有统计学意义(χ^(2)=5.165,P<0.05)。结论:2型糖尿病可以增加老年冠状动脉CTA检查后造影剂相关性肾损伤的发生率。

Objective:To investigate the relationship between type 2 diabetes and contrast-associated renal injury after coro⁃nary CT angiography(CTA)in the elderly.Methods:80 inpatients requiring coronary CTA in the hospital from December 2019 to December 2020 were selected for the study,40 of whom had no previous history of diabetes mellitus were included in group A and the other 40 had a history of diabetes mellitus were included in group B.Blood creatinine(Scr),endogenous creatinine clearance(Ccr),and urea nitrogen(BUN)were used to detect renal function,and an increase in Scr of 44.2-88.4μmol/L within 5 d after sur⁃gery was used as the criterion for renal impairment.Results:Before CTA examination,there was no statistically significant difference between group A and group B for comparison of Scr,Ccr and BUN(t=0.263,-0.255,-1.032,P>0.05).At 24 h after performing coronary CTA,there was a statistically significant difference in the comparison of Scr,Ccr,and BUN between group A and group B(t=-5.701,4.412,-3.641,P<0.05).There was a statistically significant difference in the comparison of Scr,Ccr,and BUN indexes between group A and group B at 48 h(t=-5.197,3.868,-3.622,P<0.05).There was a statistically significant difference in the comparison of Scr,Ccr,and BUN between group A and group B at 72 h(t=-3.926,3.251,-3.932,P<0.05).After coronary CTA,the incidence of renal injury was significantly lower in group A than in group B,and the difference was statistically significant(χ^(2)=5.165,P<0.05).Conclusion:Type 2 diabetes mellitus can increase the incidence of contrast-associated renal injury after coronary CTA in the elderly.