CAJ | 학술논문

目的：探讨钆贝葡胺注射液外预热对对比剂不良反应（ADR）发生率以及对患者心率、血压的影响，从而为临床上钆贝葡胺的安全使用提供依据。方法：将拟行磁共振灌注加权成像（MRPWI）的711例受检者随机分为预热组（508例）和常温组（203例）。预热组中在使用钆贝葡胺注射液前先将其放入36℃的恒温箱10～15 min，常温组中使用检查室内常温下（扫描室恒定温度22℃左右）放置的钆贝葡胺注射液。对比剂剂量0．1 mmol／kg，注射流率2．0～2．5 mL／s，经高压注射器推注。观察并记录患者 ADR 发生情况，同时记录在对比剂注射前、后预热组中111例患者及常温组中99例患者的临床生理指标（心率、血压，体温等），计算其差值，并进行统计学分析。结果：预热组的 ADR 发生率为0．2％（1／508），明显低于常温组（3％，6／203），两组间差异有统计学意义（P ＜0．05）。注射对比剂前后，常温组中患者的心率波动为（－0．41±6．84）次／分，大于预热组患者[（－2．34±5．76）次／分]，两组间差异有统计学意义（P ＜0．05）；常温组患者的舒张压波动[（－0．05±10．24）mmHg]明显大于预热组[（3．56±10．13）mmHg]，两组间差异有统计学意义（P ＜0．05）；两组患者体温波动的差异无统计学意义（P ＞0．05）。结论：钆贝葡胺注射液的外预热可有效降低 ADR 发生率且对患者心率、血压的影响较小。
목적：탐토구패포알주사액외예열대대비제불량반응（ADR）발생솔이급대환자심솔、혈압적영향，종이위림상상구패포알적안전사용제공의거。방법：장의행자공진관주가권성상（MRPWI）적711례수검자수궤분위예열조（508례）화상온조（203례）。예열조중재사용구패포알주사액전선장기방입36℃적항온상10～15 min，상온조중사용검사실내상온하（소묘실항정온도22℃좌우）방치적구패포알주사액。대비제제량0．1 mmol／kg，주사류솔2．0～2．5 mL／s，경고압주사기추주。관찰병기록환자 ADR 발생정황，동시기록재대비제주사전、후예열조중111례환자급상온조중99례환자적림상생리지표（심솔、혈압，체온등），계산기차치，병진행통계학분석。결과：예열조적 ADR 발생솔위0．2％（1／508），명현저우상온조（3％，6／203），량조간차이유통계학의의（P ＜0．05）。주사대비제전후，상온조중환자적심솔파동위（－0．41±6．84）차／분，대우예열조환자[（－2．34±5．76）차／분]，량조간차이유통계학의의（P ＜0．05）；상온조환자적서장압파동[（－0．05±10．24）mmHg]명현대우예열조[（3．56±10．13）mmHg]，량조간차이유통계학의의（P ＜0．05）；량조환자체온파동적차이무통계학의의（P ＞0．05）。결론：구패포알주사액적외예열가유효강저 ADR 발생솔차대환자심솔、혈압적영향교소。
Objectire:To explore the effects of warming of gadobenate dimeglemine injection before injection on ad-verse drug reaction (ADR)and heart rate (HR)and blood pressure of patients in magnetic resonance perfusion imaging, and then provide evidence for safe clinical application of gadobenate dimeglemine.Methods:According to warming of gado-benate dimeglemine or not,711 patients were randomly divided into warming group (508 cases)and control group (203 ca-ses).In warming group,the contrast medium was put into thermostat at 36℃,while in control group the contrast medium placed in scanning room was used without warming before injection (the temperature in scanning room was kept at 22℃). Before magnetic resonance perfusion imaging,gadobenate dimeglemine injection (0.1mmol/kg or 0.2ml/kg)was injected with flow rate of 2.0 ~2.5mL/s by a Medrad high-pressure syringe.The ADR of patients was observed and recorded, meanwhile physiological indicators (including heart rate,blood pressure and body temperature)of 111 cases in warming group and 99 cases in control group were recorded before and after injection of contrast medium,the difference of those indi-cators before and after injection was calculated and analyzed by independent sample t-test.Results:The incidence of ADR in warming group (1/508,0.2%)was significantly lower than that in control group (6/203,3%),with statistic differences (P <0.05);the changes of heart rates in the control group [(-0.41±6.84)bpm]were greater than that in warming group [(-2.34±5.76)bpm],with statistical difference (P <0.05);the changes of systolic blood pressures in the control group [(-0.05±10.24)mmHg]were significantly greater than that in warming group [(3.56 ±10.13)mmHg],with statistical difference (P <0.05);no significant difference was observed in the change of body temperature before and after injection in the two groups.Conclusion::warming of gadobenate dimeglemine injection can significantly reduce the incidences of ADR in magnetic resonance perfusion imaging examination,and causes less effect on heart rate and blood pressure.