Porri F, Vervloet D
Service de Pneumo-Allergologie, Hôpital Sainte-Marguerite, Marseille.
Allerg Immunol (Paris). 1994 Dec;26(10):374-6, 379.
ICPs are used for many radiological examinations but are responsible for 4.6 to 8.5% of secondary reactions, which may perhaps be of the toxic or anaphylactoid types. Asthma, taking of beta-blockers, and previous reactions to an ICP injection are risk factors for an anaphylactoid reaction. Several mechanisms are involved but it seems to be exceptional that there is an IgE-dependent reaction. There is no paraclinical examination for diagnosis or prediction of reactions. There are hyperosmolar ICPs and others, more recent, which are non-ionic, of reduced osmolality. Non-ionic ICPs induce only a quarter of the secondary reactions of all types together and the reactions are often less severe. When a new injection, they reduce the risk of recurrence in patients who have already had reactions. The best subject protection lies in a premedication with corticosteroids and use of a non-ionic ICP. The latter should also be prescribed if possible, in all where increase in osmolality is contraindicated.
离子型造影剂(ICPs)用于多种放射学检查,但会引发4.6%至8.5%的不良反应,这些反应可能是毒性反应或类过敏反应。哮喘、服用β受体阻滞剂以及之前对离子型造影剂注射有反应是类过敏反应的风险因素。虽然涉及多种机制,但IgE依赖反应似乎较为罕见。目前尚无用于诊断或预测不良反应的辅助检查。有高渗离子型造影剂以及其他更新的、非离子型且渗透压降低的造影剂。非离子型造影剂引发的各类不良反应总数仅为离子型造影剂的四分之一,且反应通常没那么严重。对于已发生过不良反应的患者,再次注射非离子型造影剂时,可降低复发风险。最佳的患者防护措施是使用皮质类固醇进行预处理,并使用非离子型造影剂。在所有禁忌渗透压升高的情况下,如有可能也应开具非离子型造影剂。