Berner Jeanne, Poletti Pierre-Alexandre, Becker Christoph D, Nendaz Mathieu
Service de médecine interne générale, HUG, 1211 Genève 14.
Rev Med Suisse. 2009 Oct 14;5(221):2016-8, 2020-1.
The incidence of acute iodine contrast media reactions, appearing within the first hour after the procedure, is low but clinically important due to their daily use. Previous adverse reactions to iodinated contrast media, asthma and a history of allergic reaction are the most recognized risk factors, but the identification of patients at risk remains difficult. The efficacy of preventive measures such as corticosteroid and/or antihistaminic administration rests on low-level evidence. Practical recommendations are presented in this article. Rather than relying on the sole administration of a premedication, the importance of other measures must be stressed: assessing the relevance of the indication to the radiologic exam, use of low osmolarity contrast media, and ensuring a proper monitoring of the patient during and after the procedure.
急性碘造影剂反应发生在检查后第一小时内，其发生率较低，但鉴于其每日使用，在临床上具有重要意义。既往对碘化造影剂的不良反应、哮喘和过敏反应史是最公认的危险因素，但识别高危患者仍然困难。诸如给予皮质类固醇和/或抗组胺药等预防措施的疗效证据不足。本文提出了实用建议。不应仅依赖术前用药，还必须强调其他措施的重要性：评估检查指征与放射学检查的相关性、使用低渗造影剂以及确保在检查期间和检查后对患者进行适当监测。
