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使用放射造影剂发生类过敏反应的性别风险。

Gender risk for anaphylactoid reaction to radiographic contrast media.

作者信息

Lang D M, Alpern M B, Visintainer P F, Smith S T

机构信息

Department of Medicine, Hahnemann University, Philadelphia, PA 19102-1192, USA.

出版信息

J Allergy Clin Immunol. 1995 Apr;95(4):813-7. doi: 10.1016/s0091-6749(95)70123-0.

Abstract

BACKGROUND

Female predominance has been reported previously in series of anaphylaxis cases; however, no definite precedent has been established for greater risk of anaphylactoid reaction caused by contrast media infusion on the basis of gender.

OBJECTIVE

This study was designed to determine whether greater risk for anaphylactoid reaction caused by intravenous contrast media infusion exists in association with female gender.

METHODS

Rates of anaphylactoid and severe anaphylactoid reaction, according to gender, were determined in a sample of 5264 consecutive patients receiving conventional radiocontrast media during performance of computed tomography.

RESULTS

Of 80 adverse reactions caused by contrast media infusion, 73 (1.39%) were classified as anaphylactoid in nature. Among 5191 patients who received intravenous contrast media without experiencing an anaphylactoid reaction, there were 2642 male patients (51%) and 2549 female patients (49%); reactors included 22 male patients and 51 female patients (odds ratio = 2.40, 95% confidence interval = 1.42-4.10, p < 0.0005). Female patients also comprised 21 of 22 cases of severe anaphylactoid reaction (odds ratio = 21.77, 95% confidence interval = 3.13-435.12, p < 0.0005).

CONCLUSION

Greater risk for anaphylactoid and severe anaphylactoid reaction exists in association with female gender. Further studies are needed to identify mechanisms that can explain this risk. The importance of these findings for cost-effective use of lower osmolality contrast media need to be determined.

摘要

背景

先前在一系列过敏反应病例报道中显示女性居多;然而,基于性别,对于造影剂输注引发类过敏反应风险更高这一点,尚未确立明确的先例。

目的

本研究旨在确定静脉注射造影剂引发类过敏反应的更高风险是否与女性性别相关。

方法

在5264例接受计算机断层扫描时连续接受传统放射性造影剂的患者样本中,根据性别确定类过敏反应和严重类过敏反应的发生率。

结果

在80例由造影剂输注引起的不良反应中,73例(1.39%)本质上被归类为类过敏反应。在5191例接受静脉造影剂但未发生类过敏反应的患者中,有2642例男性患者(51%)和2549例女性患者(49%);发生反应的患者包括22例男性患者和51例女性患者(优势比=2.40,95%置信区间=1.42 - 4.10,p<0.0005)。22例严重类过敏反应病例中女性患者也占21例(优势比=21.77,95%置信区间=3.13 - 435.12,p<0.0005)。

结论

女性性别与类过敏反应和严重类过敏反应的更高风险相关。需要进一步研究以确定可解释这种风险的机制。这些发现对于成本效益高的低渗造影剂使用的重要性有待确定。

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