CT增强检查中碘对比剂急性不良反应与焦虑状态的相关性

许伟; 刘艳

doi:10.11817/j.issn.1672-7347.2023.220537

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论著 | 更新时间：2023-10-24

CT增强检查中碘对比剂急性不良反应与焦虑状态的相关性
Association between acute adverse reactions to iodinated contrast media and anxiety in patients undergoing contrast-enhanced CT examination
中南大学学报(医学版) 中南大学学报(医学版) 2023年48卷第8期页码：1225-1233
作者机构：

1.中南大学湘雅三医院放射科，长沙 410013
作者简介：

许伟，Email: 383887587@qq.com, ORCID: 0000-0002-4488-1968
刘艳，Email: yan308866@163.com, ORCID: 0000-0002-6175-8566
基金信息：

湖南省自然科学基金(2019JJ50913)
DOI：10.11817/j.issn.1672-7347.2023.220537
中图分类号：
CSTR：

许伟, 刘艳. CT增强检查中碘对比剂急性不良反应与焦虑状态的相关性[J]. 中南大学学报(医学版), 2023,48(8):1225-1233.

XU Wei, LIU Yan. Association between acute adverse reactions to iodinated contrast media and anxiety in patients undergoing contrast-enhanced CT examination[J]. Journal of Central South University. Medical Science, 2023,48(8):1225-1233.
许伟, 刘艳. CT增强检查中碘对比剂急性不良反应与焦虑状态的相关性[J]. 中南大学学报(医学版), 2023,48(8):1225-1233. DOI： 10.11817/j.issn.1672-7347.2023.220537.

XU Wei, LIU Yan. Association between acute adverse reactions to iodinated contrast media and anxiety in patients undergoing contrast-enhanced CT examination[J]. Journal of Central South University. Medical Science, 2023,48(8):1225-1233. DOI： 10.11817/j.issn.1672-7347.2023.220537.

摘要

目的,2,随着影像学的发展，碘对比剂的使用越来越广泛，多项指南提出焦虑会增加碘对比剂相关不良反应的风险。本研究旨在分析焦虑状态对CT增强检查中碘对比剂急性不良反应(acute adverse reactions，AAR)发生风险的影响。,方法,2,前瞻性招募2021年2月至10月在中南大学湘雅三医院接受CT增强检查的住院患者，检查前均接受广泛性焦虑障碍量表(Generalized Anxiexy Disorde-7，GAD-7)调查并进行焦虑状态分级(轻、中、重度)及分组(AAR组和非AAR组)。比较2组的焦虑状态并利用多因素logistic回归分析筛选AAR发生的独立危险因素。采用倾向性评分匹配对2组的一般临床资料进行匹配后，再次比较2组焦虑状态的差异。,结果,2,最终纳入880例患者，匹配前AAR组(80例)和非AAR组(800例)轻至重度焦虑患者比例的差异有统计学意义(AAR组75%，非AAR组36%；,P,<,0.001)；且2组患者在工作、收入、基础疾病、过敏史等一般临床资料方面差异亦存在统计学意义(均,P,<,0.001)。2组匹配前logistic回归分析显示：患者的收入、过敏史、焦虑状态是增强CT检查碘对比剂AAR的独立危险因素(均,P,<,0.05)。将2组除焦虑外的所有因素进行倾向性评分匹配后，2组均纳入66例，其一般临床资料的差异均无统计学意义(均,P,>,0.05)，而AAR组轻至重度焦虑患者比例仍显著高于非AAR组(AAR组75%，非AAR组31%；,P,<,0.001)。,结论,2,患者接受CT增强检查时焦虑与碘对比剂AAR风险增高有关，提示检查前焦虑状态筛查有重要的临床意义。

Abstract

Objective,2,As the use of iodinated contrast media has become more widely with advances in imaging, several guidelines have suggested that anxiety increases the risk of acute adverse reactions associated with iodinated contrast media. This study aims to evaluate the impact of anxiety on the occurrence of acute adverse reactions (AAR) to iodinated contrast media in patients undergoing contrast-enhanced CT examinations.,Methods,2,Inpatients who underwent contrast-enhanced CT examinations at the Third Xiangya Hospital between February and October 2021 were prospectively recruited. Prior to the imaging examinations, all patients completed the Generalized Anxiety Disorder Scale-7 (GAD-7) assessment before the imaging examinations to determine the severity of anxiety, which was categorized as mild, moderate, or severe. Based on the occurrence of AAR, patients were classified into an AAR group and a non-AAR group. The difference in anxiety was compared between the 2 groups. Multivariate logistic regression analysis was used to identify independent risk factors associated with AAR. To ensure comparability between the 2 groups, propensity score matching (PSM) was utilized to align the clinical characteristics. Subsequently, the difference in anxiety within the matched groups was analyzed.,Results,2,The study comprised 880 patients, with 80 patients in the AAR group and 800 patients in the non-AAR group. There was a significant difference in proportion of patients with mild-severe anxiety between the 2 groups (75% in the AAR group and 36% in the non-AAR group,P,<,0.001). Additionally, differences were also observed in occupation, income, underlying diseases, and allergy history (all ,P,<,0.001). The results of multivariate logistic regression analysis revealed that patients’ income, allergy history, and anxiety were independent risk factors for AAR to iodinated contrast media (all ,P,<,0.05). Following PSM, each matched group included 66 cases, and no significant differences in clinical characteristics were observed between the 2 groups (all ,P,>,0.05). However, the proportion of patients with mild-severe anxiety remained significantly higher in the AAR group compared to the non-AAR group (75% in the AAR group and 31% in the non-AAR group,P,<,0.001).,Conclusion,2,Anxiety is associated with an increased risk of AAR to iodinated contrast media in patients undergoing contrast-enhanced CT examinations, suggesting the clinical importance of screening for anxiety before imaging examinations.

关键词

CT增强碘对比剂急性不良反应焦虑倾向性评分匹配

Keywords

contrast-enhanced CTiodinated contrast mediaacute adverse reactionsanxietypropensity score matching

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