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碘克沙醇注射液致双眼暂时失明1例并文献复习
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| 篇名： | 碘克沙醇注射液致双眼暂时失明1例并文献复习 |
| TITLE： | One case of transient bilateral blindness caused by Iodixanol injection and literature review |
| 摘要： | 目的 探讨碘克沙醇注射液致双眼暂时失明的不良反应特征，分析其发生机制、危险因素及诊疗策略，为临床安全使用该药提供参考。方法回顾性分析1例双侧椎动脉狭窄患者使用碘克沙醇注射液行介入术后出现双眼暂时失明的临床资料，结合国内外相关文献，从不良反应关联性、发生机制、危险因素、临床特征及治疗措施等方面进行系统分析。结果该患者术中使用碘克沙醇注射液约150mL，术后2h出现视物模糊，逐渐进展为双眼无光感，伴头痛、发热及肾功能一过性异常。依据药品不良反应关联性评价标准，碘克沙醇注射液与双眼暂时失明的关联性评价为“很可能”。结合病例及文献分析，推测其发生机制可能与血-脑屏障破坏、免疫反应及微栓塞相关，危险因素包括基础脑血管疾病、肾功能不全、造影剂用量较大及过敏体质。该不良反应具有起病急骤、症状复杂、可逆性显著的临床特征。经脱水、抗过敏、补液利尿、营养神经等对症治疗后，患者视力于术后第5天完全恢复，肾功能亦恢复至术前水平。结论碘克沙醇注射液致双眼暂时失明罕见但危害严重，目前确切发生机制尚未完全明确，且涉及多种危险因素。临床使用前需全面评估患者基础疾病、肾功能及过敏史，术中控制其用量，术后密切监测病情；一旦发生不良反应需及时干预，以改善患者预后。 |
| ABSTRACT： | OBJECTIVE To explore the characteristics of the transient bilateral blindness caused by Iodixanol injection， analyze its occurrence mechanism， risk factors and treatment strategies， and provide references for the safe clinical use of Iodixanol injection. METHODS A retrospective analysis was conducted on the clinical data of a patient with bilateral vertebral artery stenosis who experienced transient bilateral blindness after receiving Iodixanol injection for interventional treatment. Based on this， combined with relevant literature from both domestic and international sources， a systematic analysis was carried out from aspects such as the correlation of adverse reactions， the mechanism of occurrence， risk factors， clinical characteristics， and treatment measures. RESULTS The patient received approximately 150 mL of Iodixanol injection during the operation. Blurred vision occurred 2 hours after the procedure， which gradually progressed to no light perception in both eyes， accompanied by headache， fever and transient renal dysfunction. According to the criteria for causality assessment of adverse drug reactions， the association between Iodixanol injection and transient bilateral blindness was assessed as “probable”. Combined with analysis of the present case and relevant literature， the underlying mechanisms were speculated to be related to blood-brain barrier disruption， immune reactions and microembolism. Risk factors included underlying cerebrovascular disease， renal insufficiency， high dose of contrast medium and atopic constitution. This adverse reaction was characterized by an acute onset， complex symptoms and obvious reversibility. After symptomatic treatments such as dehydration， anti-allergy therapy， fluid infusion and diuresis， as well as neurotrophic therapy， the patient’s vision recovered completely on the 5th day after surgery， and renal function also returned to the preoperative levels. CONCLUSIONS Transient bilateral blindness induced by Iodixanol injection is rare but clinically severe. At present， its exact pathogenesis has not been fully elucidated， and it involves a variety of risk factors. Before clinical administration， it is necessary to comprehensively evaluate the patient’s underlying diseases， renal function and allergy history； control the dosage of contrast medium during the operation； and closely monitor the patient’s condition after surgery. Once adverse reactions occur， timely intervention should be taken to improve the prognosis. |
| 期刊： | 2026年第37卷第07期 |
| 作者： | 施超；舒德忠 |
| AUTHORS： | SHI Chao，SHU Dezhong |
| 关键字： | 碘克沙醇；双眼暂时失明；罕见不良反应 |
| KEYWORDS： | iodixanol； transient bilateral blindness； rare adverse drug reaction |
| 阅读数： | 16 次 |
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