四种碘造影剂在CT静脉增强应用中的对比研究

Investigation of Adverse Reactions of Four Kinds of Iodinated Contrast in CT Contrast Enhancement Scan

目的:比较四种CT静脉增强碘造影剂的不良反应,选择最佳用药。方法:CT静脉增强共2397人次,随机给予离子型造影剂安其格纳芬和非离子型造影剂优维显、双北碘海醇和欧乃派克分别为947、496、559、395例,统计分析不良反应发生率及与性别、年龄、预注射地塞米松等因素的相关性。结果:安其格纳芬、优维显、双北碘海醇和欧乃派克轻中度不良反应发生率分别为43.50%(412/947)、12.10%(60/ 496)、7.51%(42/559)和15.95%(63/395),无重度不良反应。非离子型和离子型造影剂之间不良反应存在显著差异(X^2=199.558,P=0.000)。三种非离子型造影剂之间不良反应亦存在差异,双北碘海醇不良反应最少(X^2=9.462,P=0.009)。注射地塞米松不能减少不良反应发生率。结论:非离子型造影剂比离子型造影剂更安全可靠,国产双北碘海醇不良反应最低;增强扫描前可以不需预注射地塞米松。

Objective： To evaIuate the incidence of acute adverse reactions after intravenous injection of four kinds of iodinated contrast medium in CT contrast enhancement scan. Methods： 2397 patients who underwent contrast CT scans were involved. Ionic contrast Angiografin and non-ionic contrast Ultravist, double north lohexol and Omnipaque were injected in 947, 496, 559 and 395 patients respectively. The rate of adverse reactions and the relationship with sex, age, dexamethasone injection prior to scan were assessed. Results： The mild and moderate adverse reactions rate of Angiografin. Ultravist. double north Iohexol and Oranipaque were 43.50%（412/947）, 12.10% （60/496）, 7.51%（42/559） and 15.95% （63/395）respectively （x2=199.558, P=0.O00）. The adverse rate of ionic contrast was significantly higher than non-ionic contrast, and the rate of double north Iohexol was lowest in three non-ionic contrast（x^2=9.462. P=-0.009）. Using dexamethasone prior to the injection of contrast can not decrease the incidence of adverse reaction. Conclusions： The incidence rate of adverse in non-ionic contrast is lower than ionic contrast in CT enhancement scan and the rate of adverse in domestic double north Iohexol is lowest. Injection of dexamethasone nrior to the injection of contrast is not necesary.