在新兴冠状动脉图中对对比剂的严重过敏反应
Jack Armstrong Bookbinder1, Keshav Patel2, Jeffrey Fitch2
1School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, USA jack_bookbinder@urmc.rochester.edu.
BMJ case reports
|September 3, 2025
概括
患有先前有的对比剂 (ICM) 反应的患者可能会从早期前期治疗中受益. 在转移之前立即服用类固醇可能会在急性心脏手术期间预防严重的过敏反应.
科学领域:
- 心脏病学
- 过敏和免疫学
背景情况:
- 离子对比剂 (ICM) 对于心血管成像至关重要,但可能引起不良反应.
- 患有ICM反应的患者需要谨慎管理以防止复发.
研究的目的:
- 报告患者在接受ICM治疗时出现过严重的过敏反应.
- 在接受紧急手术的高风险患者中强调早期前期治疗的潜在益处.
主要方法:
- 一名中年妇女有史以来ICM不良反应,出现ST升高心肌梗塞.
- 由于失败的血栓溶解疗法,进行了急性心脏导管治疗.
- 尽管目前医院的预先治疗,但在导管治疗过程中发生了无线性反应.
主要成果:
- 患者出现了严重的对上腺素耐药性过敏反应,需要输管和压力支持.
- 尽管在接受医院静脉注射葡萄糖皮质类药物和二胺,但反应仍发生.
结论:
- 在转移之前早期服用前期药物,特别是葡萄皮质激素,可能会减轻严重的ICM反应.
- 在患有ICM反应的患者中,对过敏反应保持警至关重要,及时预先治疗是降低风险的关键.
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