冠状动脉造影检查引起造影剂的即时和延迟不良反应的发生率:Iopamidol和Iomeprol的比较

Takanori Miura, R. Kojima, Kazumasa Negita, Akio Katsumi, M. Ota, Masayo Yamasita, T. Kubota, M. Mizutani, F. Takatsu, Yoshio Suzuki
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摘要

本研究的目的是比较370 mg I/mL的iopamidol和400 mg I/mL的iomeprol在冠脉造影中对造影剂的即时和延迟不良反应的发生率。共有4298例患者参与了这项研究,其中iopamidol组2203例,iomeprol组2093例。通过评估立即不良反应(给药后60分钟内)和延迟不良反应(血管造影后14天内)的患者数量来确定不良反应的发生率。在给药期间和给药结束后监测即时不良反应,并通过电话问卷调查延迟不良反应。两组药物之间的即时不良反应发生率无显著差异:iopamidol组为6.4%,iomeprol组为6.3%。另一方面,iomeprol治疗组的迟发性不良反应发生率(7.3%)明显低于iopamidol治疗组(9.1%)。肾功能不全患者(血清肌酸1.5 mg/dL)迟发性不良反应发生率iomeprol治疗组(41.3%)也低于iopamidol治疗组(55.2%)。上述结果显示,两组患者的即时不良反应发生率无明显差异,而iomeprol治疗组的延迟不良反应发生率较低,提示使用低渗透压的iomeprol更能保护肾功能不全患者免受造影剂不良反应的影响。
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The Incidence of Immediate and Delayed Adverse Reactions to Contrast Media Caused by Coronary Angiography Examination : A Comparison between Iopamidol and Iomeprol
The aim of this study was to compare iopamidol 370 mg I/mL with iomeprol 400 mg I/mL, regarding the incidence of immediate and delayed adverse reactions to the contrast media in patients receiving such drugs for coronary angiography. A total of 4298 patinets participated in the study consisting of 2203 and 2093 patients in the iopamidol and iomeprol groups, respectively. The incidence of adverse reactions was determined by assessing the number of patients with immediate adverse reactions (up to 60 min after drug administration) and delayed adverse reactions (within 14 days after under goin angiography). The immediate adverse reactions were monitored during and after the completion of drug administration, and delayed adverse reactions were surveyed by questionnaire over the telephone. There was no significant difference in the incidence of immediate adverse reactions between both drug groups: 6.4% for iopamidol vs. 6.3% for iomeprol. On the other hand, the incidence of delayed adverse reactions in the iomeprol-treated group (7.3%) was significantly less than that in iopamidol-treated group (9.1%). The incidence of delayed adverse reactions of patients with renal dysfunction (Serum creatine 1.5 mg/dL) in the iomeprol-treated group (41.3%) was also lower than that in the iopamidol-treated group (55.2%). These results showed no obvious difference in the incidence of immediate adverse reactions between the two groups, while the incidence of delayed adverse reactions was lower in the iomeprol-treated group, thus suggesting that the usage of iomeprol with a low osmolality was more useful in protecting patients with renal dysfunction from adverse reactions induced by contrast media.
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