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[对放射造影剂的超敏反应:诊断、预防与治疗]

[Hypersensitivity reaction to radio contrast media: diagnosis, prevention and treatment].

作者信息

Mahlab-Guri Keren, Herskovitz Pearl, Sthoeger Zev

机构信息

Department of Medicine B, Clinical Immunology, Allergy and AIDS Center, Kaplan Medical Center Rehovot, Israel affiliated to the Hebrew University-Hadassah Medical School, Jerusalem, Israel.

出版信息

Harefuah. 2012 Jul;151(7):412-5, 435.

Abstract

More than 70 million radiographic examinations with radio contrast media are performed worldwide each year. The incidence of adverse reactions to radio contrast media is 5-13%. Adverse reactions include hypersensitivity reactions, chemotoxic reactions and renal toxicity. Hypersensitivity reactions to radio contrast media range from mild pruritus to life-threatening emergency. The differential diagnosis between hypersensitivity reaction to radio contrast media and chemotoxic reaction is challenging. The incidence of chemotoxic reactions is mainly affected by the chemical structure of the radio contrast media and the rate of infusion. The incidence of hypersensitivity radio contrast media reaction is affected by age and by the presence of asthma and other atopic diseases. The diagnosis of hypersensitivity reaction to radio contrast media is based on clinical manifestations. The additional value of laboratory tests is limited and questionable. In case of hypersensitivity radio contrast reaction, the infusion should be stopped immediately, airways should be protected and fluids, oxygen and drugs should be given. Prophylactic treatment before its administration may prevent hypersensitivity reactions to radio contrast media.

摘要

全球每年使用放射性造影剂进行的放射检查超过7000万例。放射性造影剂不良反应的发生率为5%-13%。不良反应包括过敏反应、化学毒性反应和肾毒性。放射性造影剂的过敏反应范围从轻度瘙痒到危及生命的紧急情况。放射性造影剂过敏反应与化学毒性反应之间的鉴别诊断具有挑战性。化学毒性反应的发生率主要受放射性造影剂的化学结构和输注速度影响。放射性造影剂过敏反应的发生率受年龄以及哮喘和其他特应性疾病的影响。放射性造影剂过敏反应的诊断基于临床表现。实验室检查的附加价值有限且存在疑问。发生放射性造影剂过敏反应时,应立即停止输注,保护气道,并给予液体、氧气和药物。在使用前进行预防性治疗可能会预防放射性造影剂过敏反应。

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