A prospective survey of delayd adverse reactions to iodinated nonionic contrast media.

与山形县6家医院合作，对1994年10月至1995年12月接受CT和血管造影术的16700例患者进行了非离子造影剂延迟不良反应(DAR)的前瞻性调查。在16,700名患者中，有11,783人回复了问卷。DAR被定义为检查完成后超过1小时但在7天内发生的DAR。DARS总发生率为9.3%。皮疹患病率为2.9%。Isovist组皮疹发生率显著高于其他CM组(Iopamidol、Omnipaque、Imer on、Optiray)。DARS的发病风险因素如下。(1)既往无中医研究的患者。(2)有中药不良反应史的患者。(3)有过敏史的患者。(4)血清肌酐水平高于2.0 mg的患者中，有皮肤反应的患者中有44人咨询皮肤科医生。其中27人接受了过敏试验(贴剂和皮内试验)。对异丙肾上腺素和泛影葡胺有皮肤反应的患者对同一种CM的皮试阳性率分别为75%和30%，部分患者对其他CM有交叉反应；对异维斯特有皮肤反应的患者对异烟肼的皮试阳性率为67%，对其他CM无阳性交叉反应。

In the cooperation with 6 hospitals in Yamagata Prefecture, a prospective survey of delayd adverse reactions (DARs) to nonionic contrast media (CM) was conducted in 16,700 patients who underwent CT and angiography from October 1994 to December 1995. Out of 16,700 patients, 11,783 returned the questionnaire. DARs were defined as those that occurred more than 1 hour but within 7 days after completion of the examination. The overall rate of DARs was 9.3%. Prevalence of skin rash was 2.9%. Statistically higher incidence of skin rash was noted in Isovist group than the other CM (Iopamidol, Omnipaque, Iomeron, Optiray). Picked up risk factors for DARs were as follows. (1) Patients without previous CM study. (2) Patients with previous adverse reactions to CM.(3) Patients with a history of allergy. (4) Patients with higher serum creatinine level than 2.0 mg.Out of patients with skin reactions, 44 consulted dermatologists. Of these, 27 received allergy test (patch and intradermal test). Patients with skin reactions to Iopamiron and Omnipaque were positive for intradermal test to the same CM at the rate of 75% and 30% respectively, and some of them showed positive cross reactions to the other CM.Patients with skin reactions to Isovist were positive for intradermal test to it at the rate of 67%, but there was no positive cross reactions to the other CM.Further investigation might be necessary for clarifying the significance of the phenomenon in allergy tests.