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目的:探讨冠状动脉介入干预后造影剂脑病(CIE)的发病率、疾病特点、治疗方法及预后。方法:对2014-01-2016-07进行冠状动脉介入干预的1 554例患者中出现的CIE进行分析。结果:1 554例中8例(0.51%)患者出现CIE,1例表现为左、右侧交替肢体无力及意识障碍(1年前应用相同造影剂无不适),7例表现为视物模糊。8例CIE患者均应用非离子型造影剂,其中5例应用低渗造影剂碘帕醇370,2例应用等渗造影剂碘克沙醇320,1例应用低渗造影剂碘普罗胺370。8例经对症治疗后,恢复快,无神经系统后遗症。结论:CIE发生率低,非离子型的等渗和低渗造影剂均可诱发CIE,视物模糊多发,经支持治疗后预后好。对于出现CIE的患者,在需要重复应用造影剂时可慎重使用。CIE的发病机制和预防方法有待进一步研究。
Objective: To investigate the incidence, characteristics, treatment and prognosis of contrast-induced encephalopathy (CIE) after coronary intervention. METHODS: CIEs were analyzed in 1 554 patients who underwent PCI during 2014-01-2016-07. Results: CIE was found in 1 out of 554 cases (0.51%). One case showed alternating left and right limb weakness and disturbance of consciousness (the same contrast agent was applied one year ago and no discomfort). Seven cases showed blurred vision. Eight non-ionic contrast media were used in 8 patients with CIE, of which 5 were hypotonic contrast agent iopamidol 370, 2 were isotonic contrast agent iodixanol 320, and 1 was hypotonic contrast agent iopromide 370. After 8 cases of symptomatic treatment, rapid recovery, no neurological sequelae. CONCLUSIONS: The incidence of CIE is low. Non-ionic isotonic and hypotonic contrast agents can induce CIE, with blurred vision. The prognosis is good after the supportive treatment. For patients with CIE, use caution when repeated use of contrast media is required. The pathogenesis and prevention of CIE needs further study.