Chinese Medical Sciences Journal ›› 2017, Vol. 32 ›› Issue (2): 119-122.doi: 10.24920/J1001-9294.2017.015

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杜军辉1, 李蓉2,*()   

  1. 1.西安交通大学附属西安市第九医院眼科,西安,710054
    2.西安医学院第一附属医院眼科,西安, 710077
  • 收稿日期:2016-02-23 出版日期:2017-06-30 发布日期:2017-06-10
  • 通讯作者: 李蓉

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin?

Du Junhui1, Li Rong2,*()   

  1. 1Department of Ophthalmology, Xi’an Ninth Hospital, Medical College of Xi’an Jiaotong University, Xi’an, Shanxi 710054, China;
    2Department of Ophthalmology, The First Affiliated Hospital of Xi'an Medical University, Xi’an, Shanxi 710077, China;
  • Received:2016-02-23 Published:2017-06-30 Online:2017-06-10
  • Contact: Li Rong


二甲双胍是一种广泛应用于糖尿病治疗的双胍类降糖药。在临床实践中,荧光素眼底血管造影(fundus fluorescein angiography,FFA)前是否应该停用二甲双胍尚存在分歧。一些内分泌医生建议在FFA检查前停用二甲双胍,然而眼科医生在实践中并不总是认同这一观点,这种情况有时会导致不必要的医患纠纷。本文分析了造影剂肾病(contrast-induced nephropathy, CIN)的原因及相关造影剂特性,同时回顾文献中荧光素血管造影的不良反应发生情况,提出这种认识上的差异可能是由对所使用的造影剂的误解造成。糖尿病患者进行碘造影剂的血管造影发生CIN的危险性增高,必须停止二甲双胍;然而,目前尚未有使用荧光素钠进行FFA检查时发生CIN的报道。因此,FFA对口服二甲双胍的糖尿病患者是安全的,检查前没有必要停用二甲双胍。

关键词: 荧光素眼底血管造影, 糖尿病, 二甲双胍, 造影剂肾病


Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography (FFA) remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy(CIN) and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.

Key words: fundus fluorescein angiography, diabetes mellitus, metformin, contrast-induced nephropathy

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