Davidson Charles J, Erdogan Ata K
Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL, USA.
Rev Cardiovasc Med. 2008;9 Suppl 1:S24-34.
Contrast media are known to have transient hemodynamic properties that can influence a patient's clinical status, including heart rate variability and blood pressure. These changes have the potential to impact the diagnostic quality of CT scans. Although most patients are able to receive contrast media without significant adverse reactions, events occur in a minority of cases. These reactions range from mild discomfort (injection-associated pain and heat sensation) to more significant cardiac, renal, and hypersensitivity reactions. The incidence of adverse reactions varies with the type of contrast media used, and several randomized trials have elucidated the cardiac and renal differences among agents. Risk factors for contrast-induced acute kidney injury (CIAKI) have been established, with baseline kidney disease amplified by the presence of diabetes constituting the highest-risk patient group. Strategies for preventing CIAKI include antioxidant therapy, hydration regimens, and choice of contrast agents. Enhanced knowledge on the part of physicians and medical personnel regarding the properties and potential side effects of iodinated contrast agents should lead to improved patient safety and efficacy when performing radiologic examinations.
已知造影剂具有短暂的血流动力学特性,可影响患者的临床状况,包括心率变异性和血压。这些变化有可能影响CT扫描的诊断质量。虽然大多数患者能够接受造影剂且无明显不良反应,但少数情况下会发生不良反应。这些反应范围从轻微不适(注射相关疼痛和热感)到更严重的心脏、肾脏和过敏反应。不良反应的发生率因所用造影剂的类型而异,多项随机试验阐明了不同造影剂在心脏和肾脏方面的差异。已确定了造影剂诱发急性肾损伤(CIAKI)的危险因素,糖尿病患者存在基础肾病会加剧这种风险,此类患者构成最高风险患者群体。预防CIAKI的策略包括抗氧化治疗、水化方案以及造影剂的选择。医生和医务人员对碘化造影剂的特性和潜在副作用有更深入的了解,应能在进行放射学检查时提高患者安全性和检查效果。