目的 检测年轻原发性高血压病患者(≤40岁)血清中D-二聚体(D-Dimer)、超敏C反应蛋白(CRP)的表达水平并观察两者的相关性。方法 收集原发性高血压病的年轻患者40例作为观察组,无高血压病等心脑血管疾病的社区居民40例作为对照组,晨起空腹抽血,电化学发光法测定血清D-Dimer、CRP表达量,同时行Pearson检验分析两者关联性。结果 观察组血清D-Dimer、CRP表达量较对照组均升高(P＜0.05),结果存在统计学意义;观察组D-Dimer、CRP阳性率较对照组均升高(P＜0.05);且两者相关,相关系数r=0.71,P＜0.01。结论 年轻原发性高血压病患者血清D-Dimer及CRP的表达量较无高血压病居民提高,且D-Dimer与CRP在机体内的表达存在相关性,上述两种血清标记物作为高血压疾病发生、发展评价指标的相关价值值得探究。

Objective To detect the serum D-Dimer and C-reactionprotein expression levels in essential hypertension patients and observe the correlation between both of them. Methods 40 young essential hypertension patients as observer group; and 40 persons without hypertension as control group. After taking the fasting blood, the serum level of D-Dimer and CRP was detected using electrochemiluminescence method. Simultaneously, the correlation of D-Dimer with CRP was tested using Pearson correlation coefficient. Results The serum level of D-Dimer and CRP was higher in young essential hypertension patients than those in the control group. And the difference was statistically significant (P<0.05). In 80 patients, the serum levels of D-Dimer and CRP were significantly correlated, and correlation coefficient r=0.71, there was significant difference (P<0.01). Conclusion D-Dimer and CRP are significantly increased in the serum of advanced young essential hypertension patients. And the serum level of D-Dimer is significantly correlated with the serum level of CRP in young essential hypertension patients. D-Dimer as an indicator of essential hypertension after review of the value worthy of further study.

目的 探讨2型糖尿病患者发生医院感染危险因素。方法 收集2010年1月—2015年1月我院收治890例2型糖尿病患者临床资料行回顾性分析,根据是否发生医院感染分为感染组(75例)和非感染组(815例),对两组患者相关因素进行分析。结果 2型糖尿病医院感染发生率为8.43%,好发于呼吸系统感染。年龄、病程、住院时间、血糖控制差、侵袭性操作、合并并发症、合并基础疾病为2型糖尿病患者发生感染的危险因素。结论 2型糖尿病患者发生医院感染危险因素较多,临床针对高危患者应重点进行预防,降低感染率,提高患者治疗效果。

目的 分析基层医院ICU VAP的危险因素及病原学情况。方法 回顾性分析2013年1月—2014年12月本院ICU收治的机械通气>48 h 的118例患者,分VAP组和非VAP组,分析VAP的危险因素及病原学情况。结果 VAP组与非VAP组在紧急气管插管,机械通气时间,抗生素种类,糖皮质激素,PPI及镇静药物使用>7天,返流,MODS,ICU停留时间的项目,两组比较差异有统计学意义。紧急插管:52.2％ vs 31.9％,P＝0.029;机械通气时间:(9.8±3.5)vs(7.3±2.8)天,P＝0.038;抗生素种类>2种:52.2％ vs 26.4％,P＝0.005;使用糖皮质激素:56.5％ vs 27.0％,P＝0.001;PPI使用>7天:65.2％ vs 40.3％,P＝0.008;镇静药物使用>7天:58.7％ vs 38.9％,P＝0.035;返流:50％ vs 29.2％,P＝0.022;合并MODS:47.8％ vs 22.2％,P＝0.004;ICU停留时间:(13.6±6.6)vs(10.2±5.3)天,P＝0.023。使用糖皮质激素、机械通气时间、ICU停留时间是VAP的独立危险因素(多因素Logistic分析的OR值:2.481、1.234、1.075)。基层医院ICU VAP主要以革兰氏阴性菌(82.3%)为主。结论 使用激素、机械通气时间、ICU停留时间是基层医院ICU VAP的独立危险因素;而VAP病原菌感染以G-菌为主,可经验使用G-菌敏感的抗生素。

Objective To analyze pathogens and risk factors of VAP in a general ICU of a primary hospital. Methods Totally 112 patients(from 2013-01 to 2014-12) under mechanical ventilation over 48 h were retrospectively studied. The patients were assigned into VAP group and non-VAP group. The independent risk factors and pathogens of VAP were analyzed. Results There was significant difference between VAP group and non-VAP group in terms of emergent tracheal intubation, MV time, types of antibiotics used, the use of hormones,the use of PPI and sedative drugs for more than 7 days, regurgitation, MODS, ICU stay time. Emergent tracheal intubation:52.2％ vs 31.9％,P＝0.029;MV time:9.8±3.5day vs 7.3±2.8day,P＝0.038;types of antibiotics used > 2 kinds:52.2％ vs 26.4％,P＝0.005;the use of hormones:56.5％ vs 27.0％,P＝0.001;the use of PPI >7day:65.2％ vs 40.3％,P＝0.008;the use of sedative drugs >7day:58.7％ vs 38.9％,P＝0.035;regurgitation:50％ vs 29.2％,P＝0.022;MODS:47.8％ vs 22.2％,P＝0.004;ICU stay time:13.6±6.6day vs 10.2±5.3day,P＝0.023. The use of hormones,MV time, ICU stay time were the independent risk factors of VAP[odds ratio(OR) of multivariate logistic regression:2.481、1.234、1.075]. The main pathogens of VAP were gram-negative bacteria (82.3%). Conclusion The study shows that the use of hormones,MV time, ICU stay time are the independent risk factors of VAP; gram-negative bacteria are the main pathogens of VAP. Once VAP occurs, they can be treated with anti-gram-negative bacteria antibiotics.

目的 通过构建结构方程模型,分析某三级甲等综合医院腹股沟疝患者住院费用的影响因素,旨在为合理控制腹股沟疝单病种费用提供依据。方法 收集4 328份高州市人民医院2016—2022年主要诊断疾病名称为腹股沟疝且行腹股沟疝手术的患者的病历资料,预分析单个影响因素,采用AMOS28.0拟合构建模型。结果 结构方程模型拟合达到标准。性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝对总费用所产生的总效应数值分别为0.008、-0.044、0.062、0.014、-0.119、0.106、0.236;性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝通过住院时间间接对住院费用产生影响。结论 对住院费用产生的影响因素有性别、年龄、费别、住院次数、入院途径、伴随病、单双侧疝、住院时间,建议推行患者预住院模式及日间手术,在正式住院前完成相关检查,优化医疗服务流程,从而合理有效控制单病种住院费用。

Objective By utilizing a structural equation model, to analyze determinants that affect the hospitalization costs for individuals with inguinal hernia at a tertiary-level comprehensive medical center, offering insights for the potential management of costs associated with this specific ailment. Methods This study entailed the compilation of 4 328 patient files from individuals who received surgical treatment for inguinal hernia at a third-level general hospital over the period spanning 2016 to 2022. Preliminary analysis was conducted on isolated variables, followed by the development of a model using AMOS 28. 0 for fit assessment. Results The fitting of structural equation model reached the standard. The total effect values of gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia on the total cost were 0. 008, -0. 044, 0. 062, 0. 014, -0. 119, 0. 106, 0. 236, respectively. Gender, age, cost, number of hospitalizations, admission route, concomitant disease, unilateral and bilateral hernia indirectly affected hospitalization expenses through hospitalization days. Conclusions Gender, age, cost, number of hospitalizations, of admission, concomitant diseases, unilateral and bilateral hernia, and length of hospital stay have an impact on hospitalization costs. It is suggested to implement the pre-hospitalization mode and day surgery, complete relevant examinations before formal hospitalization, and optimize the medical service process, so as to reasonably and effectively control the hospitalization cost of single disease.

目的 探讨肝癌根治术后恶心呕吐现状及影响因素。方法 选取2022年5月—2024年5月天津市第二人民医院收治的70例肝癌患者进行回顾性分析,所有患者均行肝癌根治术,分析其术后恶心呕吐情况。并依照恶心呕吐发生情况进行分组,将30例术后发生恶心呕吐的患者分为观察组,其余40例患者为对照组。对比两组患者临床病理特征及围术期指标。并建立Logistic回归模型以术后恶心呕吐为因变量分析肝癌患者手术切除术后恶心呕吐的影响因素。结果 肝癌患者手术切除术后恶心呕吐发生率为42.86%（30/70）,其中Ⅰ度14例（20.00%）、Ⅱ度10例（14.29%）、Ⅲ度4例（5.71%）、Ⅳ度2例（2.86%）;观察组与对照组性别、体质量指数（BMI）、病理类型、临床分期、术前禁食时间对比差异无统计学意义（P>0.05）,观察组与对照组年龄及是否化疗情况对比差异有统计学意义（P<0.05）;观察组与对照组手术时间、术后VAS评分、麻醉方式、术后合并其他并发症情况对比差异无统计学意义（P>0.05）,观察组与对照组肝门阻断时间、术中失血量及术后腹胀情况对比差异有统计学意义（P<0.05）;年龄、是否化学治疗、术中失血量、术后腹胀情况为肝癌患者手术切除术后恶心呕吐的影响因素（P<0.05）。结论 肝癌患者手术切除术后恶心呕吐发生率较高,且年龄、是否化疗、术中失血量及术后腹胀情况可能为恶心呕吐发生的影响因素,针对此类患者高风险患者需及时采取相关措施进行干预,预防患者术后恶心呕吐情况及减轻严重程度。

Objective To explore the status and influencing factors of nausea and vomiting after radical resection of liver cancer. Methods A retrospective analysis was conducted on 70 liver cancer patients admitted to the Second People’s Hospital of Tianjin from May 2022 to May 2024. All patients underwent radical surgery for liver cancer,and their postoperative nausea and vomiting conditions were analyzed. According to the occurrence of nausea and vomiting, 30 patients who experienced nausea and vomiting after surgery were divided into an observation group, and the remaining 40 patients were divided into a control group. The clinical and pathological characteristics as well as perioperative indicators between two groups of patients were compared. A logistic regression model was established to analyze the influencing factors of postoperative nausea and vomiting in liver cancer patients after surgical resection,with postoperative nausea and vomiting as the dependent variable. Results The incidence of postoperative nausea and vomiting in liver cancer patients was 42. 86%（30/70）, including 14 cases of grade I, accounting for 20. 00%, 10 cases of grade II, accounting for 14. 29%, four cases of grade III,accounting for 5. 71%, and two cases of grade IV,accounting for 2. 86%. There were no significant differences in gender,body mass index（BMI）, pathological type,clinical stage,and preoperative fasting time between the observation group and the control group（P>0. 05）. However, there were significant differences in age and chemotherapy status between the observation group and the control group（P<0. 05）. There were no significant differences in the operation time,postoperative VAS score,anesthesia method and postoperative complications between the observation group and the control group（P>0. 05）, but with differences in the portal block time,intraoperative blood loss and postoperative abdominal distension between the observation group and the control group（P<0. 05）. Age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension were independent influencing factors for postoperative nausea and vomiting in liver cancer patients undergoing surgical resection（P<0. 05）. Conclusions The incidence of nausea and vomiting after surgical resection in liver cancer patients is relatively high, with age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension may be influencing factors for nausea and vomiting. Therefore, relevant measures should be taken in a timely manner to intervene in high-risk patients to prevent postoperative nausea and vomiting and reduce its severity.

目的 探讨肾移植术后患者膀胱痉挛发生现状及影响因素。方法 选取广州医科大学附属第一医院2022年12月—2024年4月收治的80例肾移植患者为研究对象,记录术后膀胱痉挛发生情况,将15例术后发生膀胱痉挛的患者纳入膀胱痉挛组,其余65例患者纳入非膀胱痉挛组。对比两组一般人口学资料,术前临床资料、术中及术后情况。以合并膀胱痉挛作为因变量纳入Logistics回归模型分析肾移植术后膀胱痉挛发生的影响因素。结果 80例肾移植患者在术后共有15例患者发生膀胱痉挛,占比为18.76%。膀胱痉挛组与非膀胱痉挛组的性别、年龄、体质指数、文化程度、付费方式、家庭收入比较差异无统计学意义（P>0.05）;两组原发疾病、合并基础疾病、透析方式比较差异无统计学意义（P>0.05）,两组患者术前透析时间及术前贫血情况比较差异有统计学意义（P<0.05）;两组手术时间、术中出血量、术后尿管留置时间、术后尿潴留、术后视觉模拟量表评分、C反应蛋白、肿瘤坏死因子-α、白细胞介素-6、碱性磷酸酶、谷草转氨酶、肌酐、尿素氮、胱抑素C比较差异无统计学意义（P>0.05）,两组使用尿管材质、术后7 d平均尿量比较差异有统计学意义（P<0.05）;根据Logistics回归分析结果显示,术前透析时间（95%CI：1.327~9.846,OR：3.614,P=0.012）、术前贫血（95%CI：0.995~1.000,OR：0.997,P=0.045）、尿管材质（95%CI：1.498~3 199.687,OR：69.239,P=0.030）及术后7 d平均尿量（95%CI：1.058~334.543,OR：18.813,P=0.046）为肾移植术后膀胱痉挛发生的独立影响因素（P<0.05）。结论 肾移植患者术前透析时间较长、术前贫血、应用尿管材质较硬、术后尿量少均可增加术后膀胱痉挛发生风险,因此需针对膀胱痉挛高风险患者增加护理评估,监测患者术后尿量,尽量选择软质尿管,预防肾移植术后膀胱痉挛的发生。

Objective To explore the current situation and influencing factors of bladder spasms in patients after kidney transplantation. Methods Selecting 80 kidney transplant patients admitted to the First Affiliated Hospital of Guangzhou Medical University from December 2022 to April 2024 as the research subjects, the occurrence of postoperative bladder spasm was recorded. Fifteen patients who experienced bladder spasm after surgery were included in the bladder spasm group, and the remaining 65 patients were included in the non bladder spasm group. The general demographic data,preoperative clinical data, intraoperative and postoperative conditions between two groups were compared. Incorporating bladder spasm as the dependent variable into the Logistics regression model to analyze the influencing factors of bladder spasm after kidney transplantation. Results A total of 15 out of 80 kidney transplant patients experienced bladder spasms after surgery, accounting for 18. 76%. By comparing general demographic data between the bladder spasm group and the non bladder spasm group, it was found that there were no significant differences in gender, age, Body Mass Index, education level, payment methods, and household income（P>0. 05）. There was no significant differences in primary disease, combined basic disease, and dialysis method between the two groups（P>0. 05）,while there were significant differences in preoperative dialysis time and preoperative anemia between the two groups（P<0. 05）. Surgical time, intraoperative blood loss,postoperative urinary retention, postoperative visual analog scale score, C reactive protein, tumor necrosis factor-α, interleukin-6, alkaline phosphatase, transaminase, creatinine, urea nitrogen, cystatin C were not different between the two groups（P>0. 05）. The difference in the mean urine volume after seven days and urinary catheter material were significant（P<0. 05）. According to the results of the Logistic regression analysis,preoperative dialysis duration（95%CI：1. 327-9. 846,OR：3. 614, P=0. 012）, preoperative anemia（95%CI：0. 995-1. 000,OR：0. 997, P=0. 045）, catheter material（95%CI：1. 498-3 199. 687,OR：69. 239, P=0. 030）, and mean urine output at seven days postoperatively（95%CI：1. 058-334. 543,OR：18. 813, P=0. 046）were identified as independent influencing factors for the occurrence of bladder spasms after kidney transplantation（P<0. 05）. Conclusions Renal transplant patients have a longer preoperative dialysis time, and the use of harder urinary catheter materials and lower postoperative urine output can increase the risk of postoperative bladder spasms. Therefore, it is necessary to increase nursing evaluation for high-risk patients with bladder spasms mentioned above, monitor postoperative urine output, and choose soft urinary catheters as much as possible to prevent the occurrence of bladder spasms after kidney transplantation.

       目的   分析原发性肾病综合征（PNS）患儿在糖皮质激素（激素）治疗后淋巴细胞亚群及免疫因子的水平变化，以探讨PNS耐药机制。方法   选取PNS患儿共71例，正常对照组108例，收集PNS患者在激素治疗前、后及正常对照组儿童的淋巴细胞亚群［CD4⁺ 、CD8⁺ 、CD4⁺ /CD8⁺ 、CD19⁺ 和自然杀伤（NK）细胞］及免疫因子水平，并分析激素治疗后激素敏感患儿和激素耐药患儿相关指标的差异。结果  PNS患儿淋巴细胞亚群及免疫因子水平异常，激素治疗后PNS患儿总免疫球蛋白E（IgE）水平［767.50（270.25，1 937.50）IU/mL vs 311.00（62.70，757.00）IU/mL］（P=0.008）下降，而CD4⁺ T细胞比例［（33.88±7.42）% vs（38.25±7.16）%］（P=0.004）升高，激素治疗敏感患儿NK细胞比例高于激素治疗耐药患儿［（8.39±4.60）% vs（4.72±1.99）%］（P=0.034），IgE水平低于耐药患儿［311.00（62.70，633.00）IU/mL vs783.00（88.05，1 290.00）IU/mL］（P＜0.001）。结论  PNS患儿淋巴细胞亚群分布及免疫球蛋白水平异常，激素治疗可影响患儿CD4⁺ T细胞比例及IgE水平，并且NK细胞比例和IgE水平与患儿激素耐药相关。

       Objective  To evaluate the changes of lymphocyte subsets and immune factors levels in children with primary nephrotic syndrome（PNS），and explore the pathogenesis of PNS．Methods  A total of 71 patients with PNS and 108 normal control cases were selected．Flow cytometry was used to detect the concentration of lymphocyte subsets（CD4⁺ ，CD8⁺ ，CD4⁺ /CD8⁺ ，CD19⁺  and natural killer［NK］ cells）and immune factors before and after treatment．The difference of  related factors between steroid-sensitive and steroid-resistant children after therapy were analyzed．Results  Lymphocyte subsets and immune molecule levels were abnormal in children with NPS．The level of IgE（767.50［270.25，1 937.50］IU/mL vs 311.00［62.70，757.00］IU/mL，P=0.008）was significantly decreased after therapy（P＜0.05），while CD4⁺  T cells（［33.88±7.42］% vs［38.25±7.16］%，P=0.004）were significantly increased．The level of NK cells in steroid-sensitive children was significantly higher than that in steroid-resistant children（［8.39±4.60］% vs［4.72±1.99］%，P=0.034），while the level of  IgE was significantly lower than that of steroid -resistant children（311.00［62.70，633.00］IU/mL vs 783.00［88.05，1 290.00］IU/mL，P＜0.001）．Conclusions  The distribution of lymphocyte subsets and the level of immune factors in PNS children were abnormal．Steroid therapy could affect the levels of CD4⁺  T cells and IgE，and the levels of NK cells and IgE were related to steroid-resistance in PNS children．

        目的   探讨出生胎龄＜37周早产儿发生败血症时的临床特征及其不良结局的危险因素。方法   收集2020年1月—2023年12月安徽医科大学第一附属医院本部新生儿科收治出生胎龄＜37周且发生败血症早产儿的临床资料；根据败血症发生时间分为早发型败血症（EOS）49例，晚发型败血症（LOS）150例；根据是否出现不良结局，分为结局不良组90例，结局良好组109例。分析EOS和LOS败血症的临床特征，并采用多因素Logistic回归分析早产儿败血症出现不良结局的危险因素。结果  早产儿败血症中EOS患儿出生胎龄更小，生后1 min Apgar评分更低，孕母羊水污染、胎膜早破≥18 h发生率较LOS更高（P＜0.05）；早产儿败血症临床表现无特异性，但LOS患儿休克发生率更高（P＜0.05）；早产儿易发生革兰阴性菌感染，合并先天性心脏病（OR=2.490，P＜0.05）、出生胎龄＜30周（OR=4.851，P＜0.05）、出生体质量小于1 500 g（OR=4.169，P＜0.05）是早产儿败血症发生不良结局的危险因素。结论  早产儿败血症临床表现无特异性，更易发生革兰阴性菌感染，出生胎龄越小、体质量越低发生不良结局的风险更高。

       Objective  To analyze the clinical characteristics and  risk factors of adverse outcomes of  sepsis in premature infants with gestational age ＜ 37 weeks．Methods  Clinical data of preterm infants ＜ 37 weeksof gestational age admitted to the Department of Neonatology of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2023 were collected．According to the timing of sepsis，49 cases with early-onset sepsis（EOS）and 150 cases with late-onset sepsis（LOS）were diagnosed．According to the outcome，90 cases were divided into the adverse outcome group and 109 cases were good outcome group．The clinical characteristics of EOS and LOS were analyzed，and the risk factors of adverse outcomes were analyzed by multivariate logistic regression．Results The gestational age of EOS infants was smaller at birth，the 1 minute Apgar score was lower ，and the incidence of amniotic fluid contamination and premature rupture of membranes ≥18h were higher than those in LOS infants（P＜0.05）．The clinical manifestations of sepsis in premature infants were not specific，but the incidence of shock was higher in LOS children（P＜0.05）．Preterm infants were more likely to develop gram-negative bacterial infection，congenital heart disease（OR=2.490，P＜0.05），gestational age ＜30 weeks（OR=4.851，P＜0.05），and birth weight ＜ 1 500 g（OR=4.169，P＜0.05）were identified as significant risk factors for adverse sepsis outcomes in preterm infants．Conclusions The clinical manifestations of septicemia in preterm infants are non-specific，and they are more likely to suffer from gram-negative bacterial infection．The younger the gestational age and lower the birth weight of preterm infants，the higher the risk of adverse outcomes after sepsis．

        目的   分析护生死亡态度的潜在类别及其影响因素，为开设符合我国国情的死亡教育课程提供参考。方法   采用便利抽样法，选取唐山市高校护生为调查对象。采用一般资料调查表、死亡态度描绘量表进行调查，基于潜在剖面分析护生死亡态度的类别及不同类别的影响因素。结果   共发放问卷520份，回收问卷516份，回收率为99.23%，剔除无效问卷11份，有效回收率为97.87%。护生死亡态度描绘量表得分为（96.91±13.20）分，经过剖面分析可划分为死亡态度积极-自然接受型（63.60%）和死亡态度消极-恐惧死亡型（36.40%）2个潜在类别。Logistic回归分析结果显示，陪伴临终亲友、未接触过死亡相关场所、半年内有亲友离世的护生属于死亡态度消极-恐惧死亡型的概率较大，自身性格偏外向、研究生学历的护生属于死亡态度积极-自然接受型的概率较大（均P＜0.05）。结论   护生死亡态度存在明显的分类特征，可分为死亡态度积极-自然接受型和死亡态度消极-恐惧死亡型2个潜在类别；相关院校可针对不同类别特征的护生开设死亡教育相关课程，以期帮助护生更深刻地认识死亡，树立科学死亡观。

       Objective  To analyze the potential categories and influencing factors of nursing students’ death attitude，to provide reference for setting up death education courses in line with China’s situation．Methods  Convenient sampling method was used to select nursing students in Tangshan．General data questionnaire and death attitude description scale were used to investigate the categories of nursing students’ death attitude and their influencing factors based on latent profiles．Results  A total of 520 questionnaires were sent out and 516 were collected with a rate of 99.23%．Eleven invalid questionnaires were excluded with an effective rate of 97.87%．The score of the death attitude description scale of nursing students was（96.91±13.20），which could be divided into two potential categories：positive death attitude - natural acceptance type（51.49%）and negative death attitude - fear type（48.51%）after profile analysis．Logistic regression analysis showed that nursing students who accompanied their dying relatives and friends，had no visit to death-related places，and had relatives and friends who died within six months had a higher probability of negative death attitude - fear of death，while nursing students with extrovert personality and graduate degree had a higher probability of positive death attitude - natural acceptance（all P＜0.05）．Conclusions  There were obvious classification characteristics of nursing students’ attitude towards death，which can be divided into two latent categories：positive attitude towards death - natural acceptance type and negative attitude towards death - fear type．Relevant colleges and universities can set up death education courses for nursing students with different characteristics，in order to help nursing students have a deeper understanding of death and establish a scientific view of death．

       目的   探讨电子计算机断层扫描（CT）增强碘对比剂急性不良反应发生及影响因素分析。方法   选取天津市肿瘤医院空港医院2020年10月—2023年10月收治的100例行CT增强出现碘对比剂急性不良反应的患者进行回顾性分析，将其分为观察组，另选取同期在我院行CT增强检查未发生不良反应的100例患者作为对照组。分析观察组患者碘对比剂急性不良反应情况，对比两组患者临床资料及碘对比剂注射情况，以急性不良反应作为因变量（发生急性不良反应=1，未发生急性不良反应=0）纳入Logistic回归模型，分析CT增强碘对比剂急性不良反应发生的独立影响因素。结果  100例发生碘对比剂急性不良反应的患者中轻度65例（65.00%），中度34例（34.00%），重度1例（1.00%）；观察组与对照组性别、年龄、体质指数（BMI）、高血压史、糖尿病史、心功能不全史、甲状腺功能亢进史、冠状动脉粥样硬化性心脏病史、碘对比剂使用史、食物过敏史对比差异无统计学意义（P＞0.05），观察组与对照组哮喘史（9.00% vs 2.00%）、肾功能不全史（13.00% vs 3.00%）、碘对比剂不良反应发生史（21.00% vs  2.00%）、花粉过敏史（12.00% vs 4.00%）、药物过敏史（26.00% vs 7.00%）及其他过敏史（10.00% vs 2.00%），对比差异有统计学意义（χ ² =4.710，P=0.030；χ  ² =6.790，P=0.009；χ ² =17.740，P＜0.001；χ ² =4.350，P=0.037；χ ² =13.100，P＜0.001；χ ² =5.670，P=0.017）；观察组与对照组碘对比剂剂量对比差异无统计学意义（P＞0.05），观察组与对照组碘对比剂注射速度（＜3 mL/min为55.00% vs 69.00%；≥3 mL/min为45.00% vs 31.00%）、碘对比剂类型（碘克沙醇为34.00% vs 34.00%，碘佛醇为47.00% vs 30.00%，碘海醇为19.00% vs  36.00%）对比差异有统计学意义（χ ² =4.160，P=0.041；χ ² =9.010，P=0.011）；肾功能不全史、碘对比剂不良反应发生史、药物过敏史、其他过敏史、碘对比剂注射速度为发生碘对比剂急性不良反应的影响因素（P＜0.05）。结论  CT增强碘对比剂急性不良反应多以轻度为主，且以往合并肾功能不全、碘对比剂不良反应发生史、药物过敏史、其他过敏史、碘对比剂注射速度过高可能为碘对比剂不良反应发生的影响因素。

       Objective  To explore the occurrence and influencing factors of acute adverse reactions of iodine contrast agents in enhanced computed tomography（CT）．Methods  A retrospective analysis was conducted on 100 patients admitted to our hospital from October 2020 to October 2023 who experienced acute adverse reactions to iodine contrast agents during CT enhancement．They were divided into an observation group and another 100 patients who underwent CT enhancement examination in our hospital during the same period without any adverse reactions were selected as the control group．The acute adverse  reactions of iodine contrast agent in the observation group of patients were analyzed，the clinical data and injection of iodine contrast agent between the two groups of patients were compared，and include acute adverse reactions as the dependent variable（occurrence of acute adverse reactions=1，absence of acute adverse reactions=0）was used in the Logistic regression model to analyze the independent influencing factors of acute adverse reactions of CT enhanced iodine contrast agent．Results  Among the 100 patients who experienced acute adverse reactions to iodine contrast agents，65 were mild reactions，accounting for 65.00%，34 cases had were moderate reactions，accounting for 34.00%，and one cases had severe reactions，accounting for 1.00%．There was no significant difference between the observation group and the control group in gender，age，body mass index（BMI），history of hypertension，diabetes，heart dysfunction，hyperthyroidism，coronary heart disease，use of iodine contrast agent，and food allergy（P＞0.05）．The history of asthma（9.00% vs 2.00%），renal insufficiency（13.00% vs 3.00%），adverse reactions of iodine contrast（21.00 % vs 2.00%），pollen allergy（12.00% vs  4.00%），drug allerg（26.00% vs  7.00%）and other allergies（10.00 % vs  2.00%）were significantly different（χ ² =4.710，P=0.030；χ ² =6.790，P=0.009；χ ² =17.740，P＜0.001；χ ² =4.350，P=0.037；χ ² =13.100，P＜0.001；χ ² =5.670，P=0.017）．There was no significant difference in the dosage of iodine contrast agent between the observation group and the control group（P＞0.05）．The injection rate of iodine contrast agent between the observation group and the control group（＜ 3 mL/min was 55.00% vs  69.00%；≥3 mL/min was 45.00% vs 31.00%），and the types of iodoxanol （iodoxanol［34.00% vs 34.00%］，iodoxanol［47.00% vs 30.00%］，iodohexanol［19.00% vs 36.00%］） were significantly different（χ ² =4.160，P=0.041；χ ²  =9.010，P=0.011）．History of renal insufficiency，adverse reactions to iodine contrast agents，drug allergies，other allergies，and injection speed of iodine contrast agents were independent risk factors for the occurrence of acute adverse reactions to iodine contrast agents（P＜0.05）．Conclusions  Acute adverse reactions to iodinated contrast agents in CT enhancement are mostly mild．Previous history of  renal insufficiency，history of adverse reactions to iodinated contrast agents，history of drug allergies，other allergic histories，and high injection speed of iodinated contrast agents may be influencing factors for the occurrence of adverse  reactions to iodinated contrast agents．