Enge I P
Department of Radiology, University Clinic, Aker Hospital, Oslo, Norway.
Invest Radiol. 1993 Nov;28 Suppl 5:S39-42; discussion S43. doi: 10.1097/00004424-199311001-00011.
To compare the safety of ionic and nonionic contrast agents in visceral angiography.
Beginning in 1989, a prospective, open trial was begun, and 1,890 patients who have undergone contrast injection were enrolled. Patients considered to be high risk were graded according to Palmer and received nonionic contrast media, while all other patients received ionic contrast media.
Because of the small number of visceral angiography procedures performed (38), no definitive conclusions could be drawn as to the differences between ionic and nonionic agents regarding grade-2 and grade-3 adverse events. However, a difference in grade-1 events was apparent in favor of nonionic agents.
More than 10 years ago, the Department of Radiology staff at Aker Hospital began using iohexol, first in infants, then in children, pregnant women, patients undergoing leg phlebography, and patients with serious, previously documented reactions from contrast media. Currently, the department staff administers nonionic agents exclusively for coronary angiography and other cardiac procedures in approximately 300 patients per year. Today, use of nonionic contrast media is the standard for almost all procedures requiring intra-arterial or intravenous application.
比较离子型和非离子型造影剂在内脏血管造影中的安全性。
从1989年开始,开展了一项前瞻性开放试验,纳入了1890例接受造影剂注射的患者。被认为是高风险的患者根据帕尔默标准进行分级,并接受非离子型造影剂,而所有其他患者接受离子型造影剂。
由于所进行的内脏血管造影检查数量较少(38例),关于离子型和非离子型造影剂在2级和3级不良事件方面的差异无法得出明确结论。然而,1级事件的差异明显有利于非离子型造影剂。
10多年前,阿克医院放射科工作人员开始使用碘海醇,首先用于婴儿,然后用于儿童、孕妇、接受腿部静脉造影的患者以及之前有造影剂严重不良反应记录的患者。目前,该科室工作人员每年为大约300例患者进行冠状动脉造影和其他心脏检查时仅使用非离子型造影剂。如今,对于几乎所有需要动脉内或静脉内应用造影剂的检查,使用非离子型造影剂已成为标准做法。