Canter Lauren M
Harvard Medical School, Tosteson Medical Education Center, MA 02115, USA.
Allergy Asthma Proc. 2005 May-Jun;26(3):199-203.
As the role for diagnostic and therapeutic contrast-enhanced imaging increases, review of the epidemiology, mechanisms, risk factors, and pretreatment for radiocontrast-mediated anaphylactoid reactions becomes more and more pertinent. Ongoing research has failed to elucidate the precise mechanisms of both early and late reactions, though the current data point to a multifactorial pathogenesis. The risk of reactions has decreased over time as contrast media have evolved from ionic, high-osmolality to nonionic, low-osmolality formulations; however, the expense of the low-osmolality agents limit their universal use. Today, 1-12% of patients exhibit adverse responses ranging from mild to severe, with individual risk depending on the type of contrast administered and certain baseline patient characteristics. For those high-risk patients who must receive contrast, effective pretreatment guidelines have been established.
随着诊断性和治疗性增强成像的作用不断增加，对放射性造影剂介导的类过敏反应的流行病学、机制、危险因素和预处理进行综述变得越来越重要。尽管目前的数据表明其发病机制是多因素的，但正在进行的研究仍未能阐明早期和晚期反应的确切机制。随着造影剂从离子型、高渗制剂发展到非离子型、低渗制剂，反应风险随时间有所降低；然而，低渗制剂的成本限制了它们的广泛使用。如今，1%至12%的患者会出现从轻度到重度的不良反应，个体风险取决于所用造影剂的类型和患者的某些基线特征。对于那些必须接受造影剂的高危患者，已制定了有效的预处理指南。
