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用低奥斯摩尔离子对比剂进行替代,以最大限度地减少反复出现的立即过敏反应

Sujeong Kim¹, Kyung Nyeo Jeon¹, Jae-Woo Jung¹

¹From the Division of Allergy and Clinical Immunology, Department of Internal Medicine (S.K.), and Department of Radiology (J.L.), School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea; Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea (K.N.J.); Department of Radiology, Gyeonsang National University Changwon Hospital, Changwon, Republic of Korea (K.N.J.); Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea (J.W.J.); Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea (H.K.P.); Departments of Radiology (W.L.) and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Republic of Korea (H.R.K.).

|October 31, 2023

概括

对于患有过敏反应 (HSR) 患有低度离子对比剂 (LOCM) 的患者,切换到没有常见碳酸侧链的替代LOCM,可显著减少HSR复发. 皮质类固醇前期治疗也被证明是有效的预防重复反应.

科学领域:

放射学放射学是一门学科.
药理学药理学是指药理学的学科.
临床医学临床医学

背景情况:

过敏反应 (HSR) 对低奥斯莫尔离子对比介质 (LOCM) 构成临床挑战.
预防策略,如前期治疗和切换LOCM有局限性.

研究的目的:

确定LOCM替代的最佳预防策略,在有马上HSR到LOCM的病史的患者中.

主要方法:

对1066名患者进行了回顾性研究,这些患者在LOCM之前立即出现了HSR.
用多变量一般估计方程分析对3800次后续LOCM暴露的分析.
评估包括年龄,性别,HSR严重程度,前期治疗和基于卡尔巴莫伊尔侧链的LOCM替代因素.

主要成果:

皮质类固醇前期治疗显著减少了复发的HSR (OR,0.72;P = .049).
用不同的卡巴莫伊尔侧链替换LOCM显示出类似的复发率 (OR,0.98;P = .93).
切换到没有常见卡巴莫伊尔侧链的LOCM显著降低了HSR复发率 (OR,0.51;P <.001),特别是在中度至严重的反应中.

结论:

没有常见卡巴莫伊尔侧链的替代LOCM有效地减少在任何严重程度的先前直接HSR患者中复发的HSR.
这种替代策略是管理LOCM过敏的一个有价值的预防措施.

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