碘对比剂急性不良反应回顾性分析

Retrospective analysis of acute adverse reaction of iodine contrast agents

目的探讨使用低渗或等渗碘对比剂的急性不良反应发生率、安全性与适用性,评估与急性不良反应发生相关的危险因素。方法选取我院影像中心CT增强扫描及动脉造影检查中所使用的4种碘对比剂碘海醇、碘佛醇、碘普罗胺、碘克沙醇(分别以I1、I2、I3、I4表示)急性不良反应的发生情况,用IBM SPSS 23.0统计分析软件对数据进行统计学分析,计算该时段这4种不同的低渗或等渗对比剂急性不良反应的发生率,分析其相关影响因素。结果36个月内共完成CT增强扫描10532例及动脉造影检查6130例。其中出现急性不良反应25例,发生率为0.15%。轻度急性不良反应18例,发生率0.15%;中度急性不良反应7例,发生率0.04%;重度急性不良反应0例。所使用的4种碘对比剂急性不良反应发生率差异有统计学意义(χ^(2)=5.854,P=0.022)。I4的急性不良反应发生率最高,为0.32%。I2急性不良反应发生率最低,为0.08%;I1急性不良反应发生率0.14%;I3急性不良反应发生率0.18%。其中,静脉给药不良反应发生率明显高于动脉给药患者,两者之间差异有统计学意义(χ^(2)=4.655,P=0.036)。结论等渗型对比剂碘克沙醇的急性不良反应发生率最高,低渗型对比剂碘佛醇急性不良反应发生率最低。动脉造影检查急性不良反应发生率明显低于静脉给药增强CT检查患者。

Objective Incidence of acute adverse reactions(ADR)of four kinds of iodine contrast agents were retrospectively analyzed in 10532 cases of CT enhanced scan and 6130 cases of arteriography in our hospital,and the safety of these 4 types agents in clinical application was investigated.Methods The occurrence of ADR to Iohexol,Ioversol,Iopromide and Iodixanol(expressed as I1,I2,I3 and I4)recorded in detail were analyzed by Fisher's`Exact Test.The incidences of acute adverse reactions were calculated and medicine information and features of adverse reactions induced by these 4-type agents were analyzed.Results CT enhanced scan and arteriography was performed in 16662 cases,including body enhanced scan,CTA,CTU and DSA.Acute adverse reactions occurred in 25 cases,and the incidence of ADR was 0.15%.Among them,18 cases had mild ADR(0.15%),7 cases had moderate ADR(0.04%)and nil had severe acute adverse reaction.There was a difference in the incidence of acute adverse reaction between the 4 contrast agents used(χ^(2)=5.854,P=0.022).I4 had the highest incidence of ADR,it was 0.32%,and the lowest incidence of ADR occurred in I2,it was 0.08%.The incidence of ADR with I1 and I3 was 0.14%and 0.18%,respectively.The incidence of ADR in intravenous administration was significantly higher than that in arterial administration(χ^(2)=4.655,P=0.036).Conclusion The incidence of acute adverse reaction to Iodixanol was the highest,and Ioversol was the lowest.The incidence of ADR in arteriography was significantly lower than that in patients with intravenous administration enhanced CT.