牛牛游戏厅安卓,{原始关键词}

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                              2. 当前位置: 代写一篇论文多少钱 > 医学论文 > CT对比剂发生急性不良反应的危险因素探析

                                CT对比剂发生急性不良反应的危险因素探析

                                时间:2020-05-08 09:31作者:甘淼 刘畅 赵丽 崇巍
                                本文导读:这是一篇关于CT对比剂发生急性不良反应的危险因素探析的文章,影像学检查在疾病的诊断中起到越来越重要的作用。与CT检查比较,增强CT可以更加准确观察血管、组织及器官,更容易区分正常组织和疾病区域,故更广泛应用于临床诊断。

                                  摘    要: 目的 探讨使用CT对比剂患者发生急性不良反应的相关因素。方法 收集2018年1月1日至2019年2月28日我院使用CT对比剂患者的临床资料,包括性别、年龄、使用CT对比剂种类等,根据发生急性不良反应类型及严重程度,分析CT对比剂发生急性不良反应的相关因素。结果 对比剂急性不良反应总发生率为0.068%;单因素logistic回归分析表明,年龄较小的患者易发生不良反应,碘帕醇发生不良反应的概率最小,碘普罗胺发生不良反应的概率最高(OR=133.626,95%CI:17.082~1 045.316)。多因素logistic回归分析表明,年龄小及使用碘普罗胺是发生急性不良反应的独立危险因素(均P <0.05)。碘普罗胺急性不良反应发生率最高(1.375%),急性轻度不良反应发生率高于碘帕醇、碘海醇、碘克沙醇、碘佛醇(均P <0.05);急性中度不良反应、急性过敏样不良反应发生率亦高于碘帕醇、碘海醇、碘克沙醇、碘佛醇对比剂(均P <0.001)。各对比剂严重不良反应发生率比较无统计学差异(P> 0.05)。急性过敏样不良反应患者年龄较小[51 (44~56)岁]。结论 年轻患者使用碘普罗胺时发生CT对比剂急性不良反应发生风险高。使用碘普罗胺易发生轻度、中度不良反应,也较易发生过敏样反应。发生急性过敏样不良反应常见于年轻患者。

                                  关键词: CT对比剂; 急性不良反应; 危险因素; 相关分析;

                                  Abstract: Objective To examine the factors related with acute adverse drug reactions(ADRs) in patients who undergo computed tomography(CT) with contrast agents. Methods Clinical information,including patient name,sex,and age,and type of CT contrast agent used in patients who underwent contrast-enhanced CT in our hospital between January 1,2018,and February 28,2019,was collected. According to the type and severity of the acute ADRs,the effect of patient sex and age,and the type of contrast agent used on acute ADRs was compared. Results The total incidence of acute ADRs induced by CT contrast agents was 0.068%. Univariate logistic regression analysis revealed that younger patients were more prone to adverse reactions. The probability of adverse reactions to iopalol was the lowest,and the probability of adverse reactions to iopromide was the highest(OR = 133.626,95% CI:17.082-1 045.316). A multivariate logistic regression analysis revealed that younger age and iopromide use were independent risk factors of acute ADRs(P < 0.05).The incidence of acute ADRs to iopromide(1.375%) was the highest. The incidence of acute mild and moderate ADRs and acute allergic-like adverse reactions were higher for iopromide than for other contrast agents,namely iopanol,iohexol,iodixanol,and ioversol(P < 0.05 or P < 0.001). We found no significant difference in the incidence of severe ADRs among these contrast agents(P > 0.05). Acute allergic ADRs often occurred in younger patients(51 years [range 44-56 years]). Conclusion Patients who underwent CT with iopromide and younger patients had higher risks of acute ADRs. Mild and moderate allergic reactions were more likely to occur with iopromide use,similar to allergic-like adverse reactions. Patients with acute allergic ADRs were younger.

                                  Keyword: CT contrast agent; acute adverse reaction; risk factor; correlation analysis;
                                 

                                CT对比剂发生急性不良反应的危险因素探析
                                 

                                牛牛游戏厅安卓,{原始关键词}   YINGXIANGXUEJIANCHAZAIJIBINGDEZHENDUANZHONGQIDAOYUELAIYUEZHONGYAODEZUOYONG。YUCTJIANCHABIJIAO,ZENGQIANGCTKEYIGENGJIAZHUNQUEGUANCHAXUEGUAN、ZUZHIJIQIGUAN,GENGRONGYIQUFENZHENGCHANGZUZHIHEJIBINGQUYU,GUGENGGUANGFANYINGYONGYULINCHUANGZHENDUAN[1,2]。DUIBIJIYECHENGWEIZAOYINGJI,SHIWEIGAIBIANJITIJUBUZUZHIYINGXIANGDUIBIDUERBEIYINRURENTIDETEDINGWUZHI[3]。MUQIAN,LINCHUANGSHANGGUANGFANSHIYONGDEDUIBIJIJUNHANDIAN,SUIRANZHEIXIEDUIBIJIJUNYITONGGUOANQUANRENZHENG,DANRENGKENENGDAOZHIYANZHONGWEIXIESHENGMINGDEBULIANGSHIJIAN。MUQIANDUOXIANGYANJIU[4,5]ZHICHUDIANDUIBIJIDAOZHIDEBULIANGFANYINGFASHENGLVWEI0.32%~0.64%,QIZHONGZHONGDUBULIANGFANYINGDEFASHENGLVWEI0.01%~0.04%。CHANGJIANDEBULIANGFANYINGWEIPIFUSAOYANG、QIANMAZHENDENGGUOMINYANGFANYING,CHUCIZHIWAIHAIYOUTOUTONG、EXIN、OUTUDENGQINGZHENGBULIANGFANYING,YIJIBIAOXIANWEIXUEGUANXINGSHUIZHONG、YISHISANGSHIHUOHUXIXINTIAOZHOUTINGDENGZHONGZHENGBULIANGFANYING[6]。

                                牛牛游戏厅安卓,{原始关键词}   SEONGDENG[7]GUANYUHANGUO15GEDIQUFASHENGCTDUIBIJIBULIANGFANYINGSHIJIANDEXIANGGUANYINSUFENXIFAXIAN,48 216LIBULIANGFANYINGSHIJIANZHONG6 524LI(13.5%)BAOGAOYUDIANDUIBIJISHIYONGYOUGUAN,QIZHONG,DIANPULUOAN(45.5%)、DIANHAICHUN(16.9%)、DIANPACHUN(14.3%)HEDIANMEIPUER(10.3%)FASHENGBULIANGFANYINGSHIJIANZHANZONGTIBULIANGFANYINGSHIJIANDEBILVJIAOGAO,ERDIANKESHACHUNDUODAOZHICHUXUE、NINGXUEZHANGAIYIJIMINIAOXITONGJIBING。YANJIU[8]XIANSHI,WEIJISHENGMINGDEBULIANGFANYINGJIHUDOUFASHENGZAIDUIBIJISHIYONGHOU20 minNEI,ERQIEJIXINGBULIANGFANYINGTONGCHANGBIAOXIANWEIGUOMINYANGHUOSHENGLIYANG。BUFENHUANYOUTEDINGJIBING(XINZANGJIBING、XIAOCHUAN、SHENZANGJIBINGDENG)HUANZHEZAISHIYONGCTDUIBIJISHIFASHENGJIXINGBULIANGFANYINGSHIJIANDEFENGXIANJIAOGAO,DANWUTESHUCTDUIBIJISHIYONGFENGXIANDERENQUNFASHENGJIXINGBULIANGFANYINGSHIJIANDEFENGXIANWUFAYUCE。BENYANJIUDUIWOYUANFANGSHEKESHIYONGCTDUIBIJIHUANZHELINCHUANGZILIAOJINXINGFENXI,TANTAOFASHENGJIXINGBULIANGFANYINGDEXIANGGUANYINSU,ZHIZAIWEILINCHUANGSHANGJINYIBUJIANSHAOCTDUIBIJIJIXINGBULIANGFANYINGDEFASHENGTIGONGYIJU。

                                  1、 材料与方法

                                  1.1、 研究对象

                                  SHOUJI2018NIAN1YUE1RIZHI2019NIAN2YUE28RIZHONGGUOYIKEDAXUEFUSHUDIYIYIYUANFANGSHEKESHIYONGCTDUIBIJIDE55 855LIHUANZHEDELINCHUANGZILIAO,BAOKUOXINGMING、XINGBIE、NIANLING、DENGJIHAO、SHIYONGDUIBIJIZHONGLEIHEJILIANG。PAICHUBIAOZHUN:(1)JIWANGHUANYOUXINZANGBING(ZHUDONGMAIBANXIAZHAI、CHONGXUEXINGXINLISHUAIJIEDENG)、GAOXUEYABING(XUEYA>160/90 mmHg)、SHIGEXIBAOLIU、XIAOCHUAN、FEIDONGMAIGAOYA、TANGNIAOBINGSHENBING、JIAZHUANGXIANGONGNENGKANGJIN、ZHONGZHENGJIWULI、GAOGUANGANSUANNIAO、GUSUILIU、DANBAIYICHANGXUEZHENG、FUQIUDANBAIXUEZHENG、LIANZHUANGHONGXIBAOZHENGHUANZHE;(2)CENGFASHENGGUOCTDUIBIJIDENGYAOWUGUOMINSHIJIGUOMINTIZHIHUANZHE;(3)ZHENGZAISHIYONGβSHOUTIZUZHIJI、ERJIASHUANGGUAYAOWUHUANZHE。BENYANJIUNARUHUANZHEZAIXINGZENGQIANGCTJIANCHAQIANJUNQIANSHUZHIQINGTONGYISHU。

                                  1.2、 使用碘对比剂的种类及剂量

                                  GENJUYIZHU,HUANZHEXUANYONGDIANDUIBIJIBAOKUODIANFOCHUNZHUSHEYE(ZHONGGUOJIANGSUHENGRUIYIYAOGONGSI;320 mgI/mL,100 mL/PING)、DIANHAICHUNZHUSHEYE(ZHONGGUOBEIJINGBEILUYAOYEGONGSI;35 gI:100mL)、DIANKESHACHUNZHUSHEYE(ZHONGGUOJIANGSUHENGRUIYIYAOGONGSI;27g I:100 mL)、DIANPACHUNZHUSHEYE(ZHONGGUOBEIJINGBEILUYAOYEGONGSI;37 gI:100 mL)、DIANPULUOANZHUSHEYE(DEGUOBAIERYIYAOBAOJIANGONGSI;300 mgI/mL,100 mL/PING)。

                                  1.3 、不良反应类型及严重程度分类

                                  GENJU2018NIANMEIGUOFANGSHEXUEHUIDUIBIJIZHINAN[8],JIANGBULIANGFANYINGANLEIXINGFENWEISHENGLIYANGHEGUOMINYANG,ANYANZHONGCHENGDUFENWEIQINGDU、ZHONGDUHEZHONGDU。QINGDUGUOMINYANGFANYINGBAOKUOJUXIANXINGQIANMAZHENHUOPIFUSAOYANG、JUBUPIFUSHUIZHONG、JUXIANXINGHOUBUFAYANG、BISAI、DAPENTI、JIEMOYAN、LIUTI;ZHONGDUGUOMINYANGFANYINGBAOKUOKUOSANDEQIANMAZHENHUOPIFUSAOYANG、CHIXUCUNZAIGUANGFANHONGBAN、BUBANYOUHUXIKUNNANDEYANMIANSHUIZHONG、BUBANYOUHUXIKUNNANDEHOUTOUJINGLUANHUOCUNZAIHOUMING、BUBANYOUFAYANGZHUANGTAIDECHUANXIHUOZHIQIGUANJINGLUAN;ZHONGDUGUOMINYANGFANYINGBAOKUOZHOUSHENSHUIZHONGHUOBANYOUHUXIKUNNANDEYANMIANSHUIZHONG、GUANGFANHONGBANBANDIXUEYA、HOUTOUSHUIZHONGBANCHUANMINGHUOFAYANG、BANYOUXIANZHEFAYANGZHUANGTAIDEHOUMINGHUOZHIQIGUANJINGLUAN、GUOMINXINGXIUKE。QINGDUSHENGLIXINGFANYINGBAOKUOQINGZHENGEXIN、OUTU,YIGUOXINGMIANSECHAOHONG,ZAOREHUOHANZHAN,TOUTENG、XUANYUN、JIAOLV、XIUJUEGAIBIAN,QINGDUXUEYASHENGGAO,KEZIXINGHUANJIEDEMIZOUSHENJINGFANSHE;ZHONGDUSHENGLIXINGFANYINGBAOKUOCHIXUXINGEXIN、OUTU,GAOXUEYAJIZHENG,FEIYUANFAJIBINGXIANGGUANXINGXIONGTONG,XUZHILIAOQIEDUIZHILIAOMINGANDEMIZOUSHENJINGFANSHE;ZHONGDUSHENGLIXINGFANYINGBAOKUOZHILIAODIKANGDEMIZOUSHENJINGFANSHE,XINLVSHICHANG,JINGJUE、DIANXIANFAZUO,GAOXUEYAWEIXIANG。

                                  1.4 、统计学分析

                                  CAIYONGSPSS 19.0TONGJIXUERUANJIANJINXINGFENXI,FEIZHENGTAIFENBUDEJILIANGZILIAOYIM(P25~P75)BIAOSHI,ZUJIANBIJIAOCAIYONGFEICANSHUZHIHEJIANYAN;JISHUZILIAOYILISHU(GOUCHENGBI)BIAOSHI,ZUJIANBIJIAOCAIYONGχ2JIANYANHUOFisherQUEQIEGAILVFA,SHIYONGDANYINSUHUODUOYINSUlogisticHUIGUIFENXIWEIXIANYINSU,P<0.05WEICHAYIYOUTONGJIXUEYIYI。

                                  2、 结果

                                  2.1 、对比剂急性不良反应的危险因素分析

                                牛牛游戏厅安卓,{原始关键词}   YUWEIFASHENGJIXINGBULIANGFANYINGHUANZHEBIJIAO,FASHENGJIXINGBULIANGFANYINGZUDENIANLINGXIAO、NVXINGGOUCHENGBIGAO。BUTONGDUIBIJIJIXINGBULIANGFANYINGFASHENGLVBIJIAOJIEGUOXIANSHI,DIANPULUOANJIXINGBULIANGFANYINGFASHENGLVZUIGAO,WEI1.375%,QIEQIFASHENGLVGAOYUQITADUIBIJI(JUNP<0.001),DIANFOCHUNJIXINGBULIANGFANYINGFASHENGLVGAOYUDIANPACHUN(P=0.024),QITADUIBIJIJIANJIXINGBULIANGFANYINGFASHENGLVBIJIAOCHAYIWUTONGJIXUEYIYI(JUNP>0.05),JIANBIAO1。

                                  JIANGNIANLING、XINGBIEJIDUIBIJILEIXINGNARUDANYINSUlogisticHUIGUIFENXI,JIEGUOXIANSHI,NIANLINGXIAOSHIFASHENGJIXINGBULIANGFANYINGDEWEIXIANYINSU(P<0.05),DIANPACHUNFASHENGBULIANGFANYINGDEGAILVZUIXIAO,DIANPULUOANFASHENGBULIANGFANYINGDEGAILVZUIGAO(P<0.001),JIANBIAO2。

                                  表1 使用CT对比剂患者临床资料比较
                                表1 使用CT对比剂患者临床资料比较

                                牛牛游戏厅安卓,{原始关键词}   JIANGNIANLINGJISHIYONGDUIBIJINARUDUOYINSUlogisticHUIGUIFENXI,JIEGUOXIANSHINIANLINGXIAOJISHIYONGDIANPULUOANSHIFASHENGJIXINGBULIANGFANYINGDEDULIWEIXIANYINSU(P<0.05),JIANBIAO3。

                                  2.2、 不同程度对比剂急性不良反应发生率比较

                                  JIEGUOXIANSHI,DIANPULUOANDEQINGDUHEZHONGDUJIXINGBULIANGFANYINGFASHENGLVJIAOGAO。ANZHAOJIXINGBULIANGFANYINGCHENGDUBIJIAOGEDUIBIJIJIXINGBULIANGFANYINGFASHENGLV,JIEGUOXIANSHI,DIANPULUOANQINGDUJIXINGBULIANGFANYINGFASHENGLVGAOYUDIANPACHUN、DIANHAICHUN、DIANKESHACHUNJIDIANFOCHUNDUIBIJI,CHAYIJUNYOUTONGJIXUEYIYI(PFENBIEWEI<0.001、<0.001、0.018、0.003);DIANPULUOANZHONGDUJIXINGBULIANGFANYINGFASHENGLVYIGAOYUGAOYUDIANPACHUN、DIANHAICHUN、DIANKESHACHUNJIDIANFOCHUNDUIBIJI,CHAYIJUNYOUTONGJIXUEYIYI(JUNP<0.001)。GEDUIBIJIZHONGDUJIXINGBULIANGFANYINGFASHENGLVBIJIAOJUNWUTONGJIXUECHAYI(JUNP>0.05),JIANBIAO4。

                                  表2 对比剂急性不良反应危险因素的单因素logistic回归分析
                                表2 对比剂急性不良反应危险因素的单因素logistic回归分析

                                  表3 对比剂急性不良反应危险因素的多因素logistic回归分析
                                表3 对比剂急性不良反应危险因素的多因素logistic回归分析

                                  2.3 、不同类型对比剂急性不良反应发生率比较

                                  表4 不同程度对比剂急性不良反应患者临床资料比较
                                表4 不同程度对比剂急性不良反应患者临床资料比较

                                  GUOMINYANGBULIANGFANYINGZUYUWUBULIANGFANYINGZUBIJIAONIANLINGJIAOXIAO,CHAYIYOUTONGJIXUEYIYI(P=0.005)。DIANPULUOANDEJIXINGGUOMINYANGBULIANGFANYINGFASHENGLVZUIGAO。DIANPULUOANDEJIXINGGUOMINYANGBULIANGFANYINGFASHENGLVGAOYUDIANPACHUN、DIANHAICHUN、DIANKESHACHUNJIDIANFOCHUN(JUNP<0.001)。GEDUIBIJIJIANJIXINGSHENGLIXINGBULIANGFANYINGFASHENGLVWUTONGJIXUECHAYI(JUNP>0.05),JIANBIAO5。

                                  表5 不同类型对比剂急性不良反应患者临床资料比较
                                表5 不同类型对比剂急性不良反应患者临床资料比较

                                  3 、讨论

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                                牛牛游戏厅安卓,{原始关键词}   BENYANJIUJINZAIDANZHONGXINJINXINGLEHUIGUXINGYANJIU,QIEBENYUANSHIYONGDIANDUIBIJIDEBIAOZHUNJIAOWEIYANGE,KENENGSHIBUFENJIEGUOMEIYOUTONGJIXUECHAYIDEYUANYIN,ZHEIYOUDAIYUJINYIBUWANSHAN。JINHOUJINYIBUJINXINGDUOZHONGXIN、QIANZHANXINGYANJIU,MINGQUECTDUIBIJIJIXINGBULIANGFANYINGDEWEIXIANYINSU,CONGERWEILINCHUANGJUECEYUZHIDINGYUANTIGONGYOUJIAZHIDECANKAO。

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