碘造影剂过敏反应综述

Allergy reactions induced by iodinated contrast media:a review

碘造影剂(ICM)广泛应用于血管造影、影像诊断等领域,注射ICM通常是安全的,但也可发生严重的不良反应。本文将从流行病学、分类、临床表现、危险因素、发病机制、预防等方面综述碘造影剂过敏反应进展情况。临床上发生所谓的ICM过敏反应实际上绝大多数属于类过敏反应,真正的过敏反应很少见。过敏反应可以分为4型,以Ig E介导的I型过敏反应最常见,IV型过敏反应即延迟反应通常被认为是T细胞介导的,但其机制尚不十分确切。防治措施:(1)尽量应用非离子型ICM;(2)对中、重度过敏反应者需行对症支持治疗。

Iodinated contrast media （ICM） are widely used in angiography,imaging diagnosis and other fields.ICM are generally considered to be relatively safe,but serious adverse reactions may occur.We will summarize the progress on allergy reactions induced by ICM from prevalence,classification,clinical manifestations,risk factors,pathogenesis,prevention and so on.Most hypersensitivity reactions of ICM are allergy-like reactions,the real allergic reactions are few.Allergic reactions can be divided into four kinds,type I allergic reactions are most common and it is Ig E-mediated.Type IV allergic reactions or so-called delayed reactions are usually considered T-mediated,but the pathogenesis of type IV allergic reactions is not very precise.The preventive and therapeutic measures are as follows：（1） application of nonionic ICM as far as possible;（2） the patients with moderate or severe allergic reactions to ICM should receive the symptomatic and supportive treatments.