碘对比剂脑病的研究进展  

Research progress on iodinated contrast encephalopathy

作　　者：郭爱斌 尹榕 Guo Aibin;Yin Rong(Graduate School,the First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730099,China;Department of Neurology,the 940th Hospital of PLA Joint Logistics Support Force,Lanzhou 730050,China)

机构地区：[1]甘肃省中医药大学第一临床医学院研究生院,兰州730099 [2]解放军联勤保障部队第九四〇医院神经内科,兰州730050

出　　处：《药物不良反应杂志》2021年第12期639-643,共5页Adverse Drug Reactions Journal

摘　　要：碘对比剂脑病(CIE)是使用碘对比剂(ICM)造影或介入治疗后的罕见并发症,发生率0.13%~2.92%。CIE一般发生在使用ICM数分钟至数小时后,其临床表现多样,以短暂的皮质盲最为常见。大多数患者预后良好,一般在48~72 h内可完全恢复,少数患者遗留不可逆的神经系统损害。CIE的发病机制尚未明确,可能与血脑屏障受损导致较大剂量的ICM暴露和ICM的直接细胞毒性有关。既往有慢性肾病和脑卒中病史是CIE发生的危险因素,ICM的类型和造影或介入术的部位可能对CIE的发生有一定影响。使用ICM造影或介入术后应注意观察患者是否出现神志障碍、视野缺损、癫痫等症状,一旦出现可疑症状应及时完善CT或磁共振检查,避免延误治疗。Iodinated contrast encephalopathy is a rare complication after angiography or interventional therapy with iodinated contrast medium(ICM),with an incidence of 0.13%2.92%.Iodinated contrast encephalopathy usually occurs minutes to hours after the use of ICM.Its clinical manifestations are diverse,and transient cortical blindness is the most common.Most patients have a good prognosis and generally recover completely within 4872 hours,while a few may have irreversible neurological damage.The pathogenesis of iodinated contrast encephalopathy is not clear,which may be related to highdose exposure of ICM due to the damage of bloodbrain barrier and the direct cytotoxicity of ICM.Previous history of chronic kidney disease and stroke are risk factors for iodinated contrast encephalopathy,and types of ICM and body parts of angiography or intervention may have different influence on it.After angiography or interventional treatment using ICM,whether patients have symptoms such as mental disorder,visual field defect,and epilepsy should be observed.Once suspicious symptoms appear,CT or magnetic resonance imaging should be completed in time to avoid delaying treatment.

关 键 词：对比剂 脑病 神经中毒综合征 药物相关副作用和不良反应 

分 类 号：R742[医药卫生—神经病学与精神病学]