造影期间继续使用二甲双胍对患者肾功能的影响及其相关因素分析

Effect of Metformin Administration on Renal Function and Related Factors during Angiography

目的:探讨造影期间继续使用二甲双胍对患者肾功能的影响,并分析相关影响因素。方法:收集2016年我院神经内科诊断为急性脑梗死的出院病例,筛选出住院期间使用二甲双胍并行造影检查的患者52例,比较造影前后患者肌酐清除率(Ccr)的变化,记录患者的各项临床特征,并进行相关因素分析。结果:52例患者中,24例Ccr升高,28例Ccr降低,患者造影前后Ccr差异无统计学意义。对患者的各项资料进行logistic回归分析发现,体质量(OR=0. 892,95%CI:0. 822,0. 967)和基础肌酐值(OR=1. 104 1,95%CI:1. 031,1. 181)是Ccr降低的相关因素。即体质量是Ccr降低的保护因素,而基础肌酐值是Ccr降低的危险因素。结论:造影期间继续使用二甲双胍不会对肾功能造成显著影响,但体质量较轻、基础肌酐水平较高的患者可能引起Ccr降低,应引起关注。

Objective: To investigate the effect of metformin on renal function during angiography and analyze the related factors.Methods: The diagnosis data of acute cerebral infarction in neurological department of our hospital in 2016 were collected. Totally 52 patients were treated with metformin and underwent contrast examination during hospitalization. The changes of creatinine clearance rate before and after injecting contrast medium were compared,and the various clinical characteristics of patients were recorded,and the related factors were analyzed. Results: There were no significant differences in creatinine clearance rate of all the patients before and after receiving contrast medium (paired t-tests). Among the 52 patients,24 ones had elevated creatinine clearance rate and 28 ones had reduced creatinine clearance rate. Logistic regression analysis was performed on the data of the two groups to find the risk factors for renal function. The results demonstrated the body weight (OR = 0. 892,95% CI: 0. 822,0. 967) and the baseline creatinine value (OR =1. 104 1,95% CI: 1. 031,1. 181) were the factors associated with decreased creatinine clearance rate. Conclusion: There is no significant effect on renal function by metformin administration during angiography. However,for patients with light body weight and high baseline creatinine value,it may cause the decrease of creatinine clearance rate resulting in a certain effect on renal function,which should be paid attention.