对比等渗与低渗对比剂对冠状动脉 CT 血管造影中血管衰减、图像质量和心率变化的影响：系统评价和荟萃分析。

Comparative effect of iso-osmolar versus low-osmolar contrast media on vascular attenuation, image quality, and heart rate changes in coronary CT angiography: A systematic review and meta-analysis.

机构信息

Al-Azhar University, Damietta Faculty of Medicine, New Damietta City, Damietta, Egypt.

Cairo University, Faculty of Medicine, Cairo, Egypt.

出版信息

Clin Imaging. 2020 May;61:69-79. doi: 10.1016/j.clinimag.2020.01.016. Epub 2020 Jan 16.

DOI:10.1016/j.clinimag.2020.01.016

PMID:31982704

Abstract

OBJECTIVES

Comparison of iso-osmolar contrast media (IOCM) and low-osmolar contrast media (LOCM) for vascular attenuation, image quality, heart rate changes, and common patient discomfort symptoms.

METHODS

We searched PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL). We included only randomized controlled trials. Screening, data extraction, and quality assessment were done by three independent authors. RevMan 5.3 software was used for meta-analysis.

RESULTS

Nine studies (n = 1831 participants) were found eligible and included in the meta-analysis. There was no difference between the both contrast media for vascular attenuation (mean difference = -21.31; 95% confidence interval -49.81 to 7.19; p = 0.14), image quality (standardized mean difference = 0.13; 95% confidence interval -0.07 to 0.33; p = 0.19), heart rate variability (standardized mean difference = -0.61; 95% confidence interval -1.30 to 0.09; p = 0.09), heat sensation (risk ratio = 0.79; 95% confidence interval 0.56 to 1.11; p = 0.17), and nausea or vomiting (risk ratio = 0.82; 95% confidence interval 0.52 to 1.28; p = 0.38). Moreover, IOCM resulted in a heart rate that was lower by 0.9 beat per minute (bpm) compared to LOCM (mean difference = -0.92; 95% confidence interval -1.81 to -0.03; p = 0.04).

CONCLUSIONS

Both IOCM and LOCM have similar vascular enhancement, image quality, heart rate variability, and similar risk for patient discomfort. Furthermore, IOCM resulted in a slightly lower heart rate by 0.9 bpm.

摘要

目的

比较等渗对比剂（IOCM）和低渗对比剂（LOCM）在血管衰减、图像质量、心率变化和常见患者不适症状方面的差异。

方法

我们检索了 PubMed、Web of Science、Scopus 和 Cochrane 中央对照试验注册库（CENTRAL）。仅纳入随机对照试验。由三位独立作者进行筛选、数据提取和质量评估。使用 RevMan 5.3 软件进行荟萃分析。

结果

共发现 9 项研究（n=1831 名参与者）符合纳入标准并纳入荟萃分析。两种对比剂在血管衰减（均数差=-21.31；95%置信区间-49.81 至 7.19；p=0.14）、图像质量（标准化均数差=0.13；95%置信区间-0.07 至 0.33；p=0.19）、心率变异性（标准化均数差=-0.61；95%置信区间-1.30 至 0.09；p=0.09）、热感（风险比=0.79；95%置信区间 0.56 至 1.11；p=0.17）和恶心或呕吐（风险比=0.82；95%置信区间 0.52 至 1.28；p=0.38）方面均无差异。此外，IOCM 组的心率比 LOCM 组低 0.9 次/分钟（bpm）（均数差=-0.92；95%置信区间-1.81 至-0.03；p=0.04）。