抗氧化应激治疗对老年糖尿病患者造影剂肾病的预防价值OA
Preventive value of antioxidant stress therapy for contrast-induced nephropathy in elderly patients with diabetes mellitus
目的 探讨抗氧化应激治疗对老年糖尿病患者造影剂肾病(CIN)的预防作用.方法 选择2022年1月—2024年1月保定市第二中心医院收治的老年糖尿病患者120例,采用随机数字表法分为对照组和观察组,每组60例.对照组CT增强造影检查前予以常规水化治疗,观察组在对照组基础上给予抗氧化应激治疗.记录两组CIN发生情况,比较两组造影检查前后肾功能(血清肌酐、胱抑素C和尿β2微球蛋白)、氧化应激指标(血清超氧化物歧化酶、丙二醛、谷胱甘肽过氧化物酶)水平,统计两组不良反应发生情况.结果 观察组CIN发生率[1.67%(1/60)]较对照组[13.33%(8/60)]低(P<0.05).造影检查后24 h,对照组血清肌酐、胱抑素C和尿β2微球蛋白水平较造影检查前升高,但观察组上述指标均低于对照组(P<0.05).造影检查后48、72 h,两组血清肌酐、胱抑素C和尿β2微球蛋白水平均较造影检查前升高,但观察组上述指标均低于对照组(P<0.05);造影检查后72 h,对照组血清肌酐、胱抑素C和尿β2微球蛋白水平较造影检查后48 h时升高(P<0.05).造影检查后72 h,两组血清超氧化物歧化酶、谷胱甘肽过氧化物酶水平较造影检查前降低,丙二醛水平较造影检查前升高(P<0.05);造影检查后72 h,观察组血清超氧化物歧化酶、谷胱甘肽过氧化物酶高于对照组,丙二醛水平低于对照组(P<0.05).两组不良反应总发生率比较差异无统计学意义(P>0.05).结论 抗氧化应激治疗对老年糖尿病患者CIN具有一定的预防价值,能显著改善肾功能,且不增加不良反应发生风险.
Objective To investigate the preventive value of antioxidant stress therapy for contrast-induced nephropathy(CIN)in elderly patients with diabetes mellitus(DM).Methods A total of 120 elderly DM patients admitted to the Second Central Hospital of Baoding City from January 2022 to January 2024 were selected and divided into the control group(n=60)and the observation group(n=60)by random number table method.The control group received conventional hydration treatment before contrast-enhanced CT examination,while the observation group was given antioxidant stress therapy on the basis of the control group.The occurrence of CIN in the two groups was recorded,and the renal function[serum creatinine(SCr),cystatin C(Cys C)and urine β2 microglobulin(U-β2-MG)]and oxidative stress indicators[serum superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-Px)]before and after angiography were compared between the two groups.The occurrence of adverse reactions in the two groups was also statistically analyzed.Results The incidence of CIN in the observation group[1.67%(1/60)]was lower than that in the control group[13.33%(8/60)](P<0.05).At 24 h after angiography,the levels of SCr,Cys C and U-β2-MG in the control group were higher than those before angiography,but the above indicators in the observation group were significantly lower than those in the control group(P<0.05).At 48 and 72 h after angiography,the levels of SCr,Cys C and U-β2-MG in both groups were higher than those before angiography,but the above indicators in the observation group were lower than those in the control group(P<0.05).At 72 h after angiography,the levels of SCr,Cys C and U-β2-MG in the control group were higher than those at 48 h after angiography(P<0.05).At 72 h after angiography,the levels of serum SOD,GSH-Px in both groups were lower than those before angiography,and the level of MDA was higher than that before angiography(P<0.05).At 72 h after angiography,SOD and GSH-Px in the observation group were higher than those in the control group,and the MDA level was lower than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Antioxidant stress therapy has a certain preventive value against CIN in elderly patients with DM,significantly improves renal function,and does not increase the risk of adverse reactions.
张伟;张志青
保定市第二中心医院肾内科,河北涿州 072750华北医疗健康集团石家庄华药医院内科,石家庄 050000
糖尿病造影剂肾病抗氧化应激胱抑素C尿β2微球蛋白超氧化物歧化酶谷胱甘肽过氧化物酶
diabetes mellituscontrast-induced nephropathyantioxidant stresscystatin Curinary β2 microglobulinsuperoxide dismutaseglutathione peroxidase
《临床误诊误治》 2026 (11)
52-58,7
河北省医学科学研究课题计划资助(20181090)
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