摘要
目的:分析碘克沙醇致不良反应(ADR)的临床特点,为临床安全、合理使用碘克沙醇提供参考。方法:以“碘克沙醇”和“不良反应”为关键词在中国知网、万方数据库以及维普中文科技期刊全文数据库进行检索;以“iodixanol”和“drug-related side effects and adverse reactions”为关键词在PubMed数据库进行检索,收集碘克沙醇致ADR的病例报道,同时纳入本院药品不良反应上报系统中碘克沙醇致ADR的患者信息。分析患者年龄、性别、ADR发生时间、ADR累及系统/器官及主要临床表现、治疗与转归等情况。结果:共纳入文献42篇,涉及59例患者;本院药品不良反应系统上报17例患者,共计76例,发生ADR共计76例次。其中男性42例,女性34例;年龄30~85岁。76例患者中,55例(72.37%)发生迟发性不良反应。累及系统/器官以皮肤及附件系统损害较为常见(44例次,53.66%),全身性损害次之(13例次,15.85%);主要临床表现包括皮肤及其附件过敏、过敏性休克、造影剂脑病及对比剂肾病等,腮腺炎和Kounis综合征较为罕见。除1例过敏性休克致死亡外,其余均好转或痊愈出院。结论:临床应用碘克沙醇造影期间应加强用药监测,做到早预防早处理,以免引起严重的ADR。
Objective:To analyze the clinical characteristics of adverse reactions(ADR)caused by iodixanol,providing references for clinical safety and rational use of iodixanol.Methods:The keywords“iodixanol”and“adverse reactions”were searched in CNKI,Wanfang and VIP databases,and the keywords“iodixanol”and“drug-related side eff ects and adverse reactions”were searched in PubMed database.Case reports of ADRs caused by iodixanol were collected,and patient information of ADRs caused by iodixanol was included in the adverse drug reaction reporting system of our hospital.Patients’age,gender,time of ADR occurrence,ADR system/organ involvement,main clinical manifestations,treatment and outcome were collected and analyzed.Results:A total of 42 literatures were collected,involving 59 patients.17 patients were reported to our hospital’s adverse reaction system.A total of 76 patients were involved,and 76 cases of adverse reactions occurred.The patients included 42 males and 34 females,aging from 30 to 85 years old.Among the 76 cases,55 patients(72.37%)occurred delayed adverse reactions.System/organ involvement involves skin and accessory system damage are more common(44 cases,53.66%).Systemic damage is next(13 cases,15.85%).The main clinical manifestations contained allergy to the skin and its accessories,anaphylactic shock,contrast encephalopathy and contrast nephropathy.Iodide mumps and Kounis syndrome are rare.Except for one death caused by anaphylactic shock,all the others were cured or discharged.Conclusion:During the clinical application of iodixanol angiography,medication monitoring should be strengthened to achieve early prevention and early treatment,so as to avoid serious ADR.
作者
张强
李晓莉
张晓方
ZHANG Qiang;LI Xiao-li;ZHANG Xiao-fang(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450001,China)
出处
《中国合理用药探索》
2022年第7期102-106,共5页
Chinese Journal of Rational Drug Use
