碘普罗胺致过敏性休克诱发Kounis综合征

Iopromide‑induced anaphylactic shock resulting in Kounis syndrome

1例63岁男性患者行冠状动脉CT血管造影检查,静脉注射碘普罗胺注射液100 ml。检查结束后约2 min,患者感觉胸闷、气短、全身不适,并出现全身皮肤发红,伴散在皮疹,随即出现一过性意识障碍,伴小便失禁。持续2~3 min后患者意识恢复,烦躁不安,血压为51/35 mmHg(1 mmHg=0.133 kPa),心电图示Ⅰ、AVL、V1-V5导联ST段抬高,肌钙蛋白、肌酸激酶和脑钠肽前体均升高。经抗过敏抗休克、补液扩容、抗血小板等治疗后,心电图大致正常,血压132/78 mmHg。经对病例的回顾分析及文献复习,考虑患者为碘普罗胺过敏性休克诱发Kounis综合征。

A 63‑year‑old male patient underwent coronary CT angiography and intravenous injection of 100 ml of iopromide.About 2 minutes after finishing the examination,the patient felt chest tightness,shortness of breath,general discomfort,redness of skin,and scattered rash,followed by transient disturbance of consciousness and urinary incontinence.Two to 3 minutes later,the patient regained consciousness,and was restless;the blood pressure was 51/35 mmHg.Electrocardiogram showed ST segment elevation in leads I,AVL,and V1‑V5 and increase of troponin,creatine kinase,and brain natriuretic peptide precursors.After antiallergy,antishock,fluid replacement,volume expansion,and antiplatelet treatments,electrocardiogram was normal and blood pressure was 132/78 mmHg.After retrospective analysis of cases and literature review,it was considered that the patient had Kounis syndrome resulted by iopromide‑induced anaphylactic shock.