碘对比剂不良反应的重点监测  

Study on the key monitoring of adverse reactions of iodine contrast agents

作　　者：王雨[1] 苍爱军[1] 闫明[1] WANG Yu;CANG Ai-jun;YAN Ming(Department of Pharmacy,Liaoning Provincial People＇s Hospital,Liaoning Shenyang 110016,China)

机构地区：[1]辽宁省人民医院药学部,辽宁沈阳110016

出　　处：《中国医院药学杂志》2018年第21期2254-2258,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:发现碘对比剂不良反应(ADR)特征和一般规律,为开展重点药品监测和减少临床用药风险提供参考。方法:监测碘对比剂ADR,分析碘对比剂品种、患者性别、年龄、用药时间、ADR累及器官/系统及临床表现等因素与ADR发生率的关系。结果:碘对比剂ADR总体发生率为0.51%,严重ADR发生率为0.20%。4种碘对比剂ADR发生率和严重ADR发生率无显著差异;男女碘对比剂发生率无显著差异。碘对比剂使用者ADR发生率随年龄增长呈下降趋势,20～29岁发生率最高(4.35%)。碘对比剂ADR中27.78%属于急性不良反应,72.22%属于迟发性不良反应。ADR累及多个器官/系统,主要有皮肤及其附件、中枢及外周神经系统、心率及心律、全身性损害等。过敏性休克和昏迷对症治疗后20 min～12 h可明显好转;心悸和头晕对症治疗后在2 h内可明显好转;皮疹和血管神经性水肿对症治疗一般7日内可痊愈,如使用激素可明显缩短疗程。结论:碘对比剂ADR总体发生率为偶见级别;开展重点品种监测有利于发现药品ADR的特征和规律,保障患者用药安全。OBJECTIVE To find out the characteristics and general rules of iodine contrast agent adverse reaction（ADRs）,provide references for the key drug monitoring and reducing the risks of clinical medication.METHODS The pharmacists in our hospital positively monitored the iodine contrast agent ADRs,recorded and analyzed statistically in respects of the relationship between the iodine contrast varieties,sex,age,medication time,ADR involvement in organ/system and clinical manifestations and the incidences of ADRs.RESULTS The total incidence of iodine contrast agent ADRs was 0.51%,and the incidence of serious ADRs was 0.20%.There was no significant difference in the incidence of ADRs and the incidence of severe ADRs between the four iodine contrast agents.There was no significant difference in the incidence of iodine contrast agents between men and women.The incidence of ADRs in iodine contrast medium decreased with age,and the highest incidence occurred in the range of 20-29 years old（4.35%）.27.78% of the iodine contrast agent ADRs were acute adverse reactions and 72.22%delayed adverse reactions.ADRs involved multiple organs/systems,including skin and its appendages,central and peripheral nervous system,heart rate,heart rhythm,and systemic damage.After anaphylactic shock and coma symptomatic treatment,20 min-12 h was significantly improved;palpitations and dizziness after symptomatic treatment in 2 h were significantly improved;rash and vascular nerve edema symptomatic treatment generally could be cured within7 days.For example,glucocorticoids significantly shortened the course of treatment.CONCLUSION Iodine contrast agents occasionally have adverse reactions.Key monitoring of adverse reactions is helpful to discover the characteristics and rules of drug ADRs;the measure is beneficial to ensuring the safety of the patients.

关 键 词：碘对比剂 药品不良反应 重点监测 

分 类 号：R969.3[医药卫生—药理学]