Literature analysis of 43 cases of death caused by non-ionic iodine contrast media

TIAN Hongxing; TIAN Hongyan; LI Tao; YAN Wan; LI Yue

doi:10.6039/j.issn.1001-0408.2025.13.17

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Literature analysis of 43 cases of death caused by non-ionic iodine contrast media

更新时间：2025-09-24

- Literature analysis of 43 cases of death caused by non-ionic iodine contrast media
- ZHONGGUO YAOFANG Vol. 36, Issue 13, Pages: 1655-1660(2025)
- 作者机构：
  
  贵阳市妇幼保健院药学部，贵阳　550003
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.13.17
  CLC： R981+.1;R969.3
- Received：11 December 2024，
  
  Revised：2025-04-21，
  
  Accepted：21 April 2025，
  
  Published：15 July 2025
- 稿件说明：
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田洪星,田洪艳,李韬,等.非离子型碘造影剂致患者死亡43例文献分析[J].中国药房,2025,36(13):1655-1660.

TIAN Hongxing,TIAN Hongyan,LI Tao,et al.Literature analysis of 43 cases of death caused by non-ionic iodine contrast media[J].ZHONGGUO YAOFANG,2025,36(13):1655-1660.
田洪星,田洪艳,李韬,等.非离子型碘造影剂致患者死亡43例文献分析[J].中国药房,2025,36(13):1655-1660. DOI： 10.6039/j.issn.1001-0408.2025.13.17.

TIAN Hongxing,TIAN Hongyan,LI Tao,et al.Literature analysis of 43 cases of death caused by non-ionic iodine contrast media[J].ZHONGGUO YAOFANG,2025,36(13):1655-1660. DOI： 10.6039/j.issn.1001-0408.2025.13.17.

摘要

目的

分析非离子型碘造影剂致患者死亡的特点和影响因素，并提出安全用药建议，为临床用药提供参考。

方法

检索中国知网、万方医学、维普网、PubMed、Cochrane Library、Web of Science、Embase、SpringerLink数据库，收集非离子型碘造影剂致患者死亡的病例报道，统计并分析其致患者死亡的特点和影响因素。

结果

共检索到非离子型碘造影剂致患者死亡43例，男性21例（48.84%）、女性22例（51.16%）；死亡患者的年龄以51～85岁（32例，占74.42%）为主，原患疾病以心脑血管疾病（30.23%）和消化系统疾病（30.23%）居多；仅2例患者有明确的过敏史（4.65%）；致死药物中，碘海醇（37.21%）和碘普罗胺（25.58%）占比最高，主要致死原因为过敏性休克（51.16%）、心脏骤停（11.63%）及肺水肿（11.63%）；48.84%患者的药物不良反应（ADR）发生在30 min内，62.79%的患者在发生ADR当天死亡；主要累及循环系统、神经系统和呼吸系统，表现主要为呼吸困难、血压偏低或测不到、呕吐等。

结论

非离子型碘造影剂致死药物以碘海醇和碘普罗胺为主，其不良反应发生速度快。临床需重点监测患者使用该类药物后30 min内的生命体征，及时处理呼吸困难、血压异常等症状，以降低患者死亡风险。

Abstract

OBJECTIVE

To analyze the characteristics and influencing factors of patient deaths caused by non-ionic iodine contrast media and provide recommendations for safe medication， thereby providing references for clinical application.

METHODS

Reports of fatal cases associated with non-ionic iodine contrast media were retrieved from databases including CNKI， Wanfang， VIP， PubMed， Cochrane Library， Web of Science， Embase， and SpringerLink. Statistical analysis was performed to examine the characteristics and influencing factors of these fatalities.

RESULTS

A total of 43 deaths caused by non-ionic iodine contrast media were retrieved， including 21 males （48.84%） and 22 females （51.16%）. The majority of deaths occurred in 32 patients aged 51-85 years old （74.42%）. The original diseases were mostly cardiovascular and cerebrovascular diseases （30.23%） and digestive system diseases （30.23%）， and only 2 cases had a clear allergy history （4.65%）. Among the lethal drugs， iohexol （37.21%） and iopromide （25.58%） accounted for the highest proportions. The main causes of death were anaphylactic shock （51.16%）， cardiac arrest （11.63%）， and pulmonary edema （11.63%）； 48.84% of the patients’ ADR occurred within 30 minutes， and 62.79% of the patients died on the first day. It mainly involved the circulatory system， nervous system and respiratory system， and the main manifestations were breathing difficulties， low or undetectable blood pressure， vomiting， etc.

CONCLUSIONS

The lethal drugs of non-ionic iodine contrast media are mainly iohexol and iopromide. The adverse reactions occur quickly. Clinically， it is necessary to focus on monitoring the vital signs within 30 minutes after medication， and timely treatment of symptoms such as dyspnea and abnormal blood pressure to reduce the risk of death.

关键词

Keywords

references

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