黄祥1 郭代红2 陈超2 李勇1 (1. 北京军区总医院 北京 100700；2. 解放军总医院)
摘 要 目的：调查CT扫描中碘造影剂的用药安全性与碘造影剂过敏试验的预测价值。方法：收集自1990年以来本院及全军药物不良反应监测中心碘造影剂不良反应病例报告，分析不良反应病例临床表现类型、诱发药物、高危因素个体与不良反应发生的相关性以及碘过敏试验预测价值。结果：两组不良反应病例报告分别为38例与145例，其中重度反应分别占15.8%与12.4%；诱发药物早期主要为泛影葡胺，近年则多为碘普罗胺与碘海醇；高危人群与重度不良反应密切相关。结论：近5年来碘造影剂中非离子型品种不良反应报告增多（87.1%）；碘过敏试验对提高临床用药安全性有一定的预测价值。
关键词 碘造影剂；药物不良反应；过敏性休克； 碘过敏试验
中图分类号：R981+.1
文献标识码：A
文章编号：1008-049X(2007)09-0869-03
Analysis about Adverse Drug Reactions and Clinical Use of Iodine Contrast Media
Huang Xiang1, Guo Daihong2, Chen Chao2, Li Yong1(1. General Hospital,Beijing Military Command, Beijing100700 China; 2. General Hospital of PLA)
ABSTRACT Objective: To investigate the safety of iodine contrast media in CT diagnosis and the value of skin test.Method: The reports concerned from our hospital and adverse drug reaction center of PLA were callected since 1990, information of clinical syndromes and causing agents were included. Relations between highrisk factors and incident rate of serious reactions were discussed. Value of skin test was assessed.Result: There were 38 cases and 145 cases in two groups respectively, rate of serious adverse reactions were 15.8%and 12.4% respectively. In early stage, Meglumine diatrizoate was the most causing agent, Iopromide and Iohexol were the most causing agents in later. There was evident relation between highrisk factors and serious reactions.Conclusion: In past 5 years, 87.1% causing agents are nonionic contrast medium, attention should be paid on serious reactions of these drugs, especially highrisk patients. Iodine skin test has of value in predicting the occurrence of adverse reaction.
KEY WORDS Iodine contrast media; Adverse drug reaction; Anaphylactic shock; Skin test of iodide
参 考 文 献
1 Ansell G ,Tweedie MCK ,West CR,et al.The Current Status of reactions of intravenous Contrast media［J］.Invest Radial,1980,15：32
2 周康荣.腹部CT［M］.上海：上海医科大学出版社，1993.19
3 Mentzel HJ,Blume J,Malich A,et al. Cortical blindness after contrastenhanced CT：Complication in Patient with diabetes insipidas［J］.Am J Neuroradiol，2003，24（6）：1114-1116
4 蒋彦章.类过敏反应［J］.药物流行病学杂志，1993，2（3）：150
5 国家药典委员会.临床用药须知［M］.北京：人民卫生出版社，2005.892
6 国家基本药物领导小组.国家基本药物（西药）［M］.北京：人民卫生出版社，2002.818
7 Holm F，Aschermann M，Hornig A，et al. Complications in dministration of Contrast media in the Catheterization laboratory：a 5year retrospective study［J］. Vnitr Lek，2001，47（7）：444-449
8 张远芳，刘国瑞，郭岳霖,等. 非离子型造影剂碘过敏反应的预防和处理［J］.现代医用影像学，2003，12（6）：249
9 闫素英，陈莲珍，沈芊,等.碘普罗胺注射液致心脏骤停死亡［J］.药物不良反应杂志，2005，7（2）：90 资料来自:中国药师-专业站 |