Zhang Yujing, Zhang Jiancheng, Yuan Shiying, Shu Huaqing
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Cell Neurosci. 2023 Jan 4;16:1070357. doi: 10.3389/fncel.2022.1070357. eCollection 2022.
Contrast-induced encephalopathy (CIE) is an uncommon complication associated with contrast exposure during angiographic procedures that is usually transient but occasionally leads to permanent complications or death. Due to the low incidence of CIE, there are still insufficient reports. This study was used to summarize the clinical features of CIE through a case report and systematic review. We summarized and reviewed 127 patients with CIE, and we found that the total incidence of CIE between men and women had no difference (49.61 and 50.39%, respectively), but the average age in female patients with CIE was older than that in male patients (62.19 and 58.77 years, respectively). Interestingly, the incidence of female patients with CIE in the poor prognosis group was significantly higher than that in the good prognosis group (62.50 and 36.51%, respectively), and the average age of these female patients in the poor prognosis group was younger than that in the good prognosis group (61.39 and 62.82 years, respectively). The contrast medium types were mainly nonionic (79.69 and 73.02%, respectively) and low-osmolar (54.69 and 71.43%, respectively) in both groups. Importantly, the total contrast media administrated in patients with poor prognoses was greater than that administrated in patients with good prognoses (198.07 and 188.60 ml, respectively). In addition, comorbidities in both groups included hypertension (55.91%), diabetes mellitus (20.47%), previous contrast history (15.75%), renal impairment (11.81%), and hyperlipidemia (3.15%). The percentage of patients with cerebral angiography was significantly higher in the poor prognosis group than that in the good prognosis group (37.50 and 9.52%, respectively), whereas the percentage of patients with coronary angiography in both groups had the opposite results (35.94 and 77.78%, respectively). In conclusion, CIE may not always have a benign outcome and can cause permanent deficits. Female gender, younger age, the higher dose of contrast medium, and the procedure of cerebral angiography may be related to the patient's poor prognosis.
对比剂诱导的脑病（CIE）是一种与血管造影术中使用对比剂相关的罕见并发症，通常为短暂性，但偶尔会导致永久性并发症或死亡。由于CIE的发病率较低，相关报道仍然不足。本研究通过病例报告和系统评价来总结CIE的临床特征。我们总结并回顾了127例CIE患者，发现CIE在男性和女性中的总发病率无差异（分别为49.61%和50.39%），但女性CIE患者的平均年龄高于男性患者（分别为62.19岁和58.77岁）。有趣的是，预后不良组中女性CIE患者的发病率显著高于预后良好组（分别为62.50%和36.51%），且预后不良组中这些女性患者的平均年龄低于预后良好组（分别为61.39岁和62.82岁）。两组的造影剂类型主要为非离子型（分别为79.69%和73.02%）和低渗型（分别为54.69%和71.43%）。重要的是，预后不良患者使用的造影剂总量大于预后良好患者（分别为198.07 ml和188.60 ml）。此外，两组的合并症包括高血压（55.91%）、糖尿病（20.47%）、既往造影剂使用史（15.75%）、肾功能损害（11.81%）和高脂血症（3.15%）。预后不良组中脑血管造影患者的百分比显著高于预后良好组（分别为37.50%和9.52%），而两组中冠状动脉造影患者的百分比结果相反（分别为35.94%和77.78%）。总之，CIE并非总是有良性结局，可能会导致永久性缺陷。女性、年龄较小、造影剂剂量较高以及脑血管造影操作可能与患者预后不良有关。
