Specjalski Krzysztof, Górska Lucyna, Wajda Beata, Chełmiñska Marta, Jassem Ewa
Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
Postepy Dermatol Alergol. 2020 Aug;37(4):520-523. doi: 10.5114/ada.2020.98269. Epub 2020 Sep 2.
Iodinated contrast media (ICM) are pharmaceuticals widely used in diagnostic procedures. Adverse effects associated with their administration are quite frequent and mostly mild. However, they raise concerns in patients and doctors in the context of their future use.
To determine efficacy of premedication before medical procedures with the use of iodinated contrast media in patients with a history suggesting a hypersensitivity reaction after their past use.
Out of 152 patients consulted due to adverse reactions after ICM (85 women and 67 men, aged 43-90), 101 were selected with the history suggesting a mild hypersensitivity reaction (urticaria, itching, skin redness, malaise etc.). All the patients had health problems requiring a procedure with ICMadministration in the near future. The premedication was given with cetirizine (10 mg) and prednisone (20 mg or 50 mg, randomly assigned) 13, 7 and 1 h before the ICM administration. Presence of adverse events was compared between the subgroups with χ test and efficacy of premedication - with Wilcoxon test.
Seventy-six patients underwent the radiologic procedure with premedication with antihistamine and a lower (40 patients) or higher dose (36 patients) of prednisone. Four of them reported a cutaneous hypersensitivity reaction (urticaria, itching, redness) and one - dyspnoea. There was no statistically significant difference in relation to the premedication protocol ( = 0.1306).
Premedication with cetirizine and prednisone before radiologic procedures proved to be efficient in patients with a history suggesting hypersensitivity to iodinated contrast media. There was no significant difference in efficacy related to the dose of prednisone (20 mg vs. 50 mg).
碘化造影剂（ICM）是广泛用于诊断程序的药物。与其给药相关的不良反应相当常见，且大多轻微。然而，在其未来使用方面，它们引起了患者和医生的关注。
确定在有既往使用碘化造影剂后疑似过敏反应病史的患者中，在进行医疗程序前使用碘化造影剂时进行预处理的疗效。
在因使用ICM后出现不良反应而就诊的152例患者（85名女性和67名男性，年龄43 - 90岁）中，选择了101例有疑似轻度过敏反应（荨麻疹、瘙痒、皮肤发红、不适等）病史的患者。所有患者都有健康问题，需要在不久的将来进行使用ICM的程序。在注射ICM前13、7和1小时给予西替利嗪（10毫克）和泼尼松（20毫克或50毫克，随机分配）进行预处理。通过χ检验比较亚组之间不良事件的发生情况，并通过Wilcoxon检验比较预处理的疗效。
76例患者在使用抗组胺药和较低剂量（40例患者）或较高剂量（36例患者）泼尼松预处理后接受了放射学检查。其中4例报告有皮肤过敏反应（荨麻疹、瘙痒、发红），1例报告有呼吸困难。与预处理方案相关的差异无统计学意义（P = 0.1306）。
对于有疑似对碘化造影剂过敏病史的患者，在放射学检查前使用西替利嗪和泼尼松进行预处理被证明是有效的。与泼尼松剂量（20毫克与50毫克）相关的疗效无显著差异。
