Bottinor Wendy, Polkampally Pritam, Jovin Ion
Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia.
Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, Virginia.
Int J Angiol. 2013 Sep;22(3):149-54. doi: 10.1055/s-0033-1348885.
The use of iodinated contrast agents for angiography dates back to the 1920s. With over 75 million contrast-requiring procedures performed annually worldwide, it is important to understand the risk factors, pathogenesis, diagnosis, prevention, and treatment of adverse reactions caused by iodinated contrast media (ICM). As contrast media have evolved from ionic, high-osmolality to nonionic, low-osmolality formulations the risk of reactions has decreased over time; however, no pretreatment protocol has been shown to eliminate all repeat reactions. Clinical alertness and early recognition of adverse reactions is of paramount importance and key for appropriate management of these patients. In this article, we review the most recent literature regarding adverse reactions to ICM and provide an insight into the pathogenesis, clinical presentation, pretreatment, and management of contrast-related reactions.
碘化造影剂用于血管造影可追溯到20世纪20年代。全球每年有超过7500万例需要使用造影剂的检查,因此了解碘化造影剂(ICM)引起不良反应的危险因素、发病机制、诊断、预防及治疗非常重要。随着造影剂从离子型、高渗制剂发展到非离子型、低渗制剂,不良反应的风险随时间有所降低;然而,尚无预处理方案能消除所有复发性反应。临床警觉性及对不良反应的早期识别对于这些患者的恰当处理至关重要。在本文中,我们回顾了关于ICM不良反应的最新文献,并深入探讨造影剂相关反应的发病机制、临床表现、预处理及处理方法。