碘帕醇致高血压急症  

Hypertensive emergency caused by iopamidol

作　　者：梁海霞[1] 周建博[2] 张嵊鹏[3,4] 朱莹[3,5] 宋智慧[3] 

机构地区：[1]首都医科大学附属北京安定医院药学部,100088 [2]首都医科大学附属北京同仁医院内分泌科,100041 [3]首都医科大学附属北京同仁医院药学部,100041 [4]首都医科大学宣武医院药学部 [5]首都医科大学附属北京朝阳医院药学部

出　　处：《药物不良反应杂志》2017年第1期67-68,共2页Adverse Drug Reactions Journal

摘　　要：1例52岁高血压、糖尿病女性患者因双下肢动脉轻中度病变行CT血管造影检查，检查前血压135／73mmHg（1mmHg=0．133kPa）。动脉注射碘帕醇[37g（I）／100m1]65ml后约1h，患者出现头晕、恶心、呕吐、乏力，血压升至183／93mmHg。服用降压药物后约1h症状缓解，血压150／90mmHg。约5．5h后，患者上述症状复现，血压升至260／120mmHg。给予乌拉地尔100mg静脉泵入（泵速为3．0～6．0mg／h）。约3．5h后，患者血压降至160／80mmHg，头晕、恶心、呕吐等症状消失。停用乌拉地尔，给予卡托普利12．5mg顿服。随后经不断调整降压方案，患者血压控制在140-150／70-80mmHg。A 52-year-old female patient with hypertension and diabetes mellitus had mild and moderate arterial lesions of bilateral lower extremities. The computed tomographic angiography （CTA） was performed to clarify the degree of vascular stenosis. Before examination, this patient＇s blood pressure was 135/73 mmHg. She was given intraarterial iopamidol [37 g（I） /100 ml] 65 ml. About one hour after the intraarterial injection, she experienced dizziness, nausea, vomiting and fatigue, her blood pressure increased to 183/93 mmHg. After taking antihypertensive drugs for about one hour, those symptoms relieved and blood pressure was 150/90 mmHg. At about 5. 5 hours, the above clinical symptoms reappeared and blood pressure rose to 260/120 mmHg. Urapidil 100 mg was administered through continuous intravenous pump and the pump speed was 3. 045.0 mg/h. After 3.5 hours of treatment, the blood pressure decreased to 160/ 80 mmHg and the clinical symptoms of dizziness, nausea and vomiting disappeared. Therefore urapidil was stopped and captopril 12.5 mg was temporarily orally administered. Though the constant adjustment of antihypertensive therapy, the patient＇s blood pressure was stable at 140-150/70-80 mmHg.

关 键 词：碘帕醇 高血压 恶性 

分 类 号：R544.1[医药卫生—心血管疾病]