CCAAT增强子结合蛋白A（CEBPA）是调节血液发育过程中髓系分化和造血干祖细胞活性的关键转录因子之一。CEBPA基因突变常见于急性髓系白血病（AML）中,最近研究表明CEBPA bZIP框内单位点和经典双等位基因突变AML患者均具有类似的临床特征,已被单独划分为AML亚群。CEBPA bZIP框内突变而非传统的双等位CEBPA基因突变成为AML良好预后的分子指标,表明其在AML疾病进展和治疗预后中的重要性和特殊性。本文将从CEBPA蛋白在血液系统中的功能、CEBPA bZIP框内突变AML的临床特征与分子作用机制、以及伴CEBPA突变AML的治疗现状等方面进行综述,为进一步研究CEBPA bZIP框内突变在AML中的致病性和精准治疗新药物开发提供参考。

CCAAT enhancer-binding protein A（CEBPA）is one of the key transcription factors regulating myeloid differentiation and hematopoietic stem/progenitor cell maintenance during hematopoiesis．CEBPA gene mutations are commonly found in acute myeloid leukemia（AML）．Recent studies have demonstrated that AML patients haboring single CEBPA bZIP in-frame mutations or classical bi-allelic CEBPA mutations show similar clinical features and it has been individually classified as AML subgroup．Additionally,it is CEBPA bZIP in-frame mutations rather than the traditional biallelic CEBPA mutations that have emerged as a molecular indicator of favorable prognosis for clinical AML management,suggesting its importance and specificity in AML disease progression and therapeutic prognosis．Here,we reviewed serval aspects including the hematopoietic function of CEBPA protein,the clinical features and molecular mechanisms of AML with CEBPA bZIP in-frame mutations,and the current status of the treatment of AML with CEBPA mutations,which will provide a reference for further study of the pathogenicity of CEBPA bZIP in-frame mutations in AML and the development of new drugs for precision therapy．

目的 分析类风湿因子（RF）、T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）与类风湿关节炎病情程度的关系。方法 选取2023年1月—2024年4月收治的90例类风湿关节炎患者作为观察组,同期到院的90例健康体检者为对照组,均接受RF、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺检测,并按照类风湿关节炎患者病情评价（DAS28）判定观察组患者病情的严重程度,应用Pearson相关性分析RF、CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺与患者病情严重程度的关系。结果 与对照组比较,观察组RF及CD8⁺水平较高,CD3⁺、CD4⁺及CD4⁺/CD8⁺水平较低（P<0.05）;不同病情的RF及CD8⁺水平比较,重度患者最高,其次为中度、轻度,而CD3⁺、CD4⁺及CD4⁺/CD8⁺水平比较,轻度患者最高,其次为中度、重度,两两比较均有差异统计学意义（P<0.05）;经Pearson相关性分析,RF及CD8⁺水平与病情程度呈正相关,CD3⁺、CD4⁺及CD4⁺/CD8⁺水平与病情程度呈负相关（P<0.05）。结论 RF、T淋巴细胞亚群指标与类风湿关节炎发生、发展有密切关系,可为医师准确评估患者病情严重程度提供可靠参考。

Objective To analyze the relationship between rheumatoid factor（RF）,T lymphocyte subsets（CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺）and the severity of rheumatoid arthritis．Methods A total of 90 patients with rheumatoid arthritis from January 2023 to April 2024 were selected as the observation group,and 90 healthy checkup individuals who came to the hospital during the same period were selected as the control group．All patients underwent RF,CD3⁺,CD4⁺,CD8⁺,and CD4⁺/CD8⁺ tests,and the severity of their condition was determined based on the evaluation of rheumatoid arthritis patient condition（DAS28）． Pearson Correlation analysis was used to analyze the relationship between RF,CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺ and the disease severity of the patients．Results Compared with the control group,RF and CD8⁺ levels in the observation group were higher,while the levels of CD3⁺,CD4⁺ and CD4⁺/CD8⁺ were low（P<0.05）．Comparison of RF and CD8⁺ levels for different conditions,the RF and CD8⁺ levels of the severe patients was highest,followed by moderate and mild．However,the CD3⁺,CD4⁺ and CD4⁺/CD8⁺ levels were highest in mild patients,followed by the moderate and sereve patients．Statistical significance was found in both pairwise comparisons（P<0.05）．After the Pearson correlation analysis,RF and CD8⁺ levels were positively correlated with the degree of disease,while CD3⁺,CD4⁺,and CD4⁺/CD8⁺ levels were inversely associated with the degree of disease condition（P<0.05）．Conclusions RF and T lymphocyte subsets are closely related to the occurrence and development of rheumatoid arthritis,and can provide reliable references for physicians to accurately evaluate the severity of patients' conditions．

目的 探析子宫输卵管超声造影（D-HyCoSy）配合宫腔水造影对不孕症患者宫腔粘连（IUA）诊断灵敏度、特异度情况。方法 选取2021年1月—2023年2月南华大学附属长沙中心医院的110例不孕症者为研究对象,均予以宫腔水造影、D-HyCoSy,以宫腔镜病理结果为金标准,分析不同诊断方法应用的效果。结果 在110例不孕症患者中,经宫腔镜病理检查发现,宫腔粘连患者占比47.27%（52/110）。D-HyCoSy的诊断准确率为76.36%、宫腔水造影的为79.09%,均低于联合诊断的93.63%（P<0.05）。D-HyCoSy的诊断灵敏度为73.08%,宫腔水造影的为80.77%,均低于联合诊断的94.23%,差异具有统计学意义（P<0.05）。D-HyCoSy的诊断特异度为79.31%,宫腔水造影的为77.59%,与联合诊断的93.10%相比,差异无统计学意义（P>0.05）。结论 对于不孕症患者,予以宫腔水造影联合D-HyCoSy诊断,其诊断效能高于单一诊断检查率,能更准确地判定宫腔粘连,效能高。

目的 探讨CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。方法 对2021年5月—2024年5月商丘市第一人民医院收治的82例非小细胞肺癌手术治疗患者进行回顾性分析,将其分为观察组,另选取82例肺部良性肿瘤患者作为对照组,收集其术前CT增强延迟扫描结果,以术后病理诊断结果为金标准,分析CT增强延迟扫描技术在非小细胞肺癌术前诊断中的应用价值。并对比不同临床病理特征非小细胞肺癌患者CT增强延迟扫描的CT增强值,采用Spearman相关性分析法分析CT增强值与非小细胞肺癌病理特征的关系。结果 CT增强延迟扫描显示观察组患者分叶征（12.50% vs 53.57%）、内部空泡征数量（6.25% vs 39.29%）低于对照组（χ²=26.560、24.680,P<0.05）,观察组患者边缘毛刺（56.25% vs 17.86%）、胸部凹陷征（59.38% vs 14.29%）、高于对照组（χ²=43.330、64.600,P<0.05）;82例非小细胞肺癌通过CT增强延迟扫描共确诊79例,CT增强延迟扫描诊断对非小细胞肺癌的准确率为96.34%（79/82）,与病理诊断结果100.00%对比差异无统计学意义（χ²=3.060,P=0.080）;82例非小细胞肺癌平均CT增强值为（39.14±7.31）,不同性别、年龄、肿瘤最大直径、淋巴结浸润情况患者CT增强值对比差异无统计学意义（P>0.05）,不同病理类型[腺癌（43.75±7.15）vs 鳞癌（34.74±6.12）]、细胞分化程度[中、低分化（45.71±7.21）vs 高分化（32.81±5.11）]、临床分期[Ⅰ期（31.03±2.12）vs Ⅱ期（36.61±3.13）vs Ⅲa期（46.32±6.83）]患者、淋巴结转移[是（42.75±4.21）vs 否（35.77±8.13）]CT增强值对比差异有统计学意义（t/F=5.243、8.804、84.828、4.378,P<0.05）;Spearman相关分析结果显示：病理类型、细胞分化程度、临床分期、淋巴结转移与非小细胞肺癌患者CT增强值呈正相关（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008,P<0.05）。结论 CT增强延迟扫描技术对非小细胞肺癌术前确诊具有重要价值,其诊断准确率与病理诊断并无显著差异,且可通过CT增强延迟扫描技术确定患者CT增强值,从而为非小细胞肺癌患者术后病理特征判断提供参考。

Objective To explore the application value of CT enhanced delayed scanning in preoperative diagnosis of non-small cell lung cancer（NSCLC）．Methods A retrospective analysis was conducted on 82 patients with NSCLC who underwent surgical treatment in a hospital from May 2021 to May 2024．They were included into an observation group and another 82 patients with benign lung tumors were included in the control group．The preoperative CT enhanced delayed scanning results were collected,and the postoperative pathological diagnosis was used as the “gold standard” to analyze the application value of CT enhanced delayed scanning in the preoperative diagnosis of NSCLC．And the CT enhancement values of delayed CT scans in NSCLC patients with different clinical and pathological features were compared,and Spearman correlation analysis was used to analyze the relationship between CT enhancement values and pathological features of NSCLC．Results CT enhanced delayed scanning showed that the number of lobular（12.50% vs 53.57%）and internal vacuolar signs（6.25% vs 39.29%）in the observation group was significantly lower than that in the control group（χ²=26.560,24.680,P<0.05）,while the edge spicules（56.25% vs 17.86%）and chest depression signs（59.38% vs 14.29%）in the observation group were significantly higher than that in the control group（χ²=43.330,64.600,P<0.05）．A total of 79 cases of 82 NSCLC were diagnosed by CT-enhanced delayed scan,and the accuracy of CT-enhanced delayed scan diagnosis for NSCLC was 96.34%（79/82）,with no significant difference from the pathological diagnosis result of 100.00%（χ²=3.060,P=0.080）．The average CT enhancement value of 82 NSCLC cases was（39.14±7.31）．There was no significant difference in CT enhancement values among patients of different genders,ages,maximum tumor diameter,and lymph node infiltration（P>0.05）．Patients with different pathological types [adenocarcinoma（43.75±7.15）vs squamous cell carcinoma（34.74±6.12）],degree of cell differentiation [moderate,and low differentiation（45.7±7.21）vs high differentiation（32.81±5.11）],clinical stage [I（31.03±2.12）vs II（36.61±3.13）vs IIIa（46.32±6.83）] and lymph node metastasis [yes（42.75±4.21）,vs no（35.77±8.13）] CT enhancement had significant difference（t/F=5.243,8.804,84.828,4.378,P<0.05）．The Spearman correlation analysis results showed that pathological type,degree of cell differentiation,clinical stage,lymph node metastasis were positively correlated with CT enhancement values in NSCLC patients（r=0.431,P=0.021;r=0.511,P=0.009;r=0.586,P=0.005;r=0.579,P=0.008）．Conclusions CT enhanced delayed scanning has important value in preoperative diagnosis of NSCLC．Its diagnostic accuracy is not significantly different from pathological diagnosis,and the CT enhanced value of patients can be determined through CT enhanced delayed scanning,providing reference for postoperative pathological feature judgment of NSCLC patients．

目的 评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法 通过CNKI（中国知网）、万方数据库、VIP（维普）、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3 381个满足纳入排除要求的随机对照试验。结果 以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA（用于评估疗效的指标）=95%,排名第一。结论 根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。

Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation．Methods Through CNKI,Wanfang database,VIP,PubMed,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied．Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined．Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3 381 RCTs meeting the inclusion and exclusion requirements were selected．Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle + electroacupuncture ranked first with sucra=81.6%．According to the visual analogy score,the silver needle sucra=95%,ranking first．Conclusions According to the existing research evidence,pestle needle + electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove．

目的 基于SEER数据库分析三阴性乳腺癌（TNBC）的预后,并建立Cox回归临床预测模型且进行内部验证。方法 使用SEER*Stat软件（8.4.2版）筛选2010—2015年诊断为TNBC的病例,进行单因素和Cox多因素回归以及向后逐步回归分析,明确与生存相关的独立危险因素,构建预测TNBC患者3年和5年癌症特异生存（CSS）率的Nomogram图,并用受试者工作特征曲线,Harrell’s一致性指数,临床预测模型校准曲线以及决策曲线对该模型进行评估及内部验证,以评估该模型的临床预测效能。结果 共筛选出符合纳入标准的TNBC患者5 564例,按照7∶3的比例随机拆分为训练集（n=3 894）和验证集（n=1 670）。通过单因素,多因素分析显示TNM分期、放射治疗、化学治疗以及手术和其他治疗的先后顺序是与TNBC患者CSS显著相关的独立危险因素（P<0.05）。利用上述预后相关因素建立Nomogram图模型。训练集的C-index为0.731（95%CI：0.712~0.749）,验证集的C-index为0.719（95%CI：0.688~0.749）,训练集和验证集3年和5年生存ROC曲线的曲线下面积均>0.7,区分度较好,且校准曲线拟合良好。结论 TNM分期、放射治疗、化学治疗以及手术和其他治疗的先后顺序是TNBC的独立预后因素,基于此建立的Nomogram图临床预测模型区分度、准确度以及临床适用性较好,能较好地预测TNBC患者的生存预后。

Objective To analyze the prognosis of triple negative breast cancer（TNBC）based on the SEER database,and to establish a Cox regression clinical prediction model with internal validation．Methods Cases diagnosed with TNBC from 2010 to 2015 were screened using SEER*Stat software（version 8.4.2）,and univariate and Cox multifactorial regression as well as backward stepwise regression analyses were performed to identify the independent risk factors associated with survival,and to construct a clinical prediction model for predicting the three- and five-year cancer specific survival（CSV）of TNBC patients．Survival（CSS）rates of TNBC patients at 3 and 5 years,and the model was evaluated and internally validated using the ROC curve,Harrell’s consistency index（C-index）,clinical prediction model calibration curve,and decision-making curve（DCA curve）to assess the predictive efficacy of the model for clinical prediction．Results A total of 5 564 TNBC patients meeting the inclusion criteria were screened and randomly split into a training set（n=3 894）and a validation set（n=1 670）according to a 7∶3 ratio．By univariate,multivariate analysis showed that T-stage,N-stage,M-stage,radiotherapy,chemotherapy,and the sequence of surgery and other treatments were independent risk factors significantly associated with CSS in TNBC patients．The above prognostic-related factors were utilized to build a Nomogram plot model．The C-index was 0.731（95%CI：0.712-0.749）for the training set and 0.719（95%CI：0.688-0.749）for the validation set,and the areas under the curves of the 3- and 5-year survival ROC curves of both the training and validation sets were >0.7,which was a good differentiation,and the calibration curves were well-fitted．Conclusions T-stage,N-stage,M-stage,radiotherapy,chemotherapy,and the sequence of surgery and other treatments are independent prognostic factors for TNBC,and the Nomogram clinical prediction model based on this has good differentiation,accuracy,and clinical utility,and can better predict the survival prognosis of TNBC patients．

目的 探讨NXT629改善肝胆结石形成的相关机制。方法 对C57BL/6J小鼠分别采用常规饮食或成石饮食（LD）喂养,并在LD组小鼠注射PPAR-α拮抗剂NXT629。通过苏木精-伊红染色法染色分析肝脂肪病变,油红O染色检测肝脏脂质的积累,分光光度法检测胆汁或血清中总胆固醇、甘油三酯、磷脂、总胆汁酸、胆固醇饱和指数、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇指标;qPCR法检测小鼠肝组织中ABCG5/8、CYP7A1、CYP7B1、PPAR-α和ABCB11 mRNA的表达情况。结果 NXT629通过靶向PPAR-α降低LD组小鼠肝脏中的ABCG5、ABCG8、ABCB11 mRNA水平以及增加CYP7A1、CYP7B1 mRNA水平,进而减少LD诱导的肝胆结石形成并改善脂质代谢紊乱。结论 NXT629可能通过影响脂代谢相关基因表达改善肝胆结石。

Objective To explore the mechanism on NXT629 improves hepatolithiasis formation．Methods C57BL/6J mice were fed either a regular diet or a lithogenic diet（LD）,with the LD group receiving injections of PPAR-α inhibitor NXT629．Liver steatosis was analyzed via HE staining,hepatic lipid accumulation was detected by Oil Red O staining,and total cholesterol,triglycerides,phospholipids,total bile acids,cholesterol saturation index,low density lipoprotein cholesterol,and high density lipoprotein cholesterol levels in bile or serum were measured using assay kits．RT-qPCR was employed to determine the mRNA expression of ABCG5/8,CYP7A1,CYP7B1,PPAR-α,and ABCB11 in mouse liver tissues．Results The Results showed that NXT629 target PPAR-α to down-regulate the mRNA levels of ABCG5,ABCG8,and ABCB11 in the livers of LD-fed mice,while increasing the mRNA levels of CYP7A1 and CYP7B1,thereby reducing LD-induced hepatolithiasis formation and improving lipid metabolism disorders．Conclusions NXT629 can improve cholesterol gallstones by affecting the expression of genes related to lipid metabolism．

目的 探讨重楼皂苷Ⅰ（PPI）对慢性髓系白血病细胞（K562）细胞的抑制作用及可能的作用机制。方法 采用CCK-8法筛选药物最适浓度,将培养时间为24 h的药物最适浓度作为后续实验的干预浓度。分组如下：（1）空白组;（2）PPI组;（3）抑制剂组;（4）PPI+抑制剂组。采用CCK-8法检测细胞增殖率;AO/EB染色观察细胞形态;流式细胞术检测凋亡率;ROS检测试剂盒检测活性氧（ROS）含量、还原型谷胱甘肽含量检测试剂盒检测谷胱甘肽（GSH）含量、细胞亚铁比色法测试盒检测细胞亚铁（Fe²⁺）含量;qRT-PCR法和蛋白免疫印迹法检测各组肿瘤蛋白53（p53）、钠氯离子依赖性氨基酸转运蛋白11（SLC7A11）、谷胱甘肽过氧化物酶4（GPX4）mRNA及蛋白表达量。结果 PPI抑制K562细胞的生长,且呈一定的剂量及时间依赖性（与同时间段的对照组0μmol/L比较,均P<0.01）。与空白组相比,PPI抑制K562细胞的增殖,提高了凋亡率,而铁死亡抑制剂（Ferrostian-1）的使用逆转了PPI对K562凋亡的促进作用（P<0.01）。与空白组相比,PPI组ROS、Fe²⁺含量升高,GSH含量下降,而铁死亡抑制剂的使用可下调ROS、Fe²⁺,上调GSH的含量（P<0.01）。PPI组较空白组p53 mRNA和蛋白表达水平升高,而SLC7A11、GPX4 mRNA和蛋白表达水平下降（P<0.05）;PPI+抑制剂组细胞较重楼皂苷组p53 mRNA和蛋白表达水平下降,而SLC7A11、GPX4 mRNA和蛋白表达水平升高（P<0.05）。结论 PPI能够有效抑制K562细胞增殖,促进K562细胞铁死亡,其分子机制可能与p53信号通路的调控有关。

Objective To investigate the inhibitory effect of polyphyllin I（PPI）on chronic myeloid leukemia cells（K562）and its possible mechanism．Methods K562 cell line was cultured in suitable environment,and the optimal concentration of the drug was screened by CCK-8 method．The optimal concentration of the drug cultured for 24 hours was used as the intervention concentration of the follow-up experiment．Cells were divided into the following groups：（1）blank group,（2）saponins group,（3）inhibitor group and（4）saponins + inhibitor group．The cell proliferation rate was detected by CCK-8 method．The cell morphology was observed by AO/EB staining．The apoptosis rate was detected by flow cytometry．The contents of reactive oxygen species（ROS）,glutathione（GSH）and ferrous（Fe²⁺）in different groups were detected,and the expression of mRNA and protein in different groups were detected by qRT- PCR and Western blot respectively．Results PPI significantly inhibited the growth of K562 cells in a dose-and time-dependent manner．Compared with the blank group,PPI significantly inhibited the proliferation of K562 cells and increased the apoptosis rate of K562 cells,while the use of ferroptosis inhibitor（Ferrostian-1）reversed the promoting effect of PPI on apoptosis of K562 cells．Compared with the blank group,the contents of reactive oxygen species（ROS）and ferrous iron（Fe²⁺）increased and the content of glutathione（GSH）decreased in the saponins group．The use of Ferrostian-1 could down-regulate the contents of ROS and Fe²⁺ and increase the content of GSH in the cells treated with the drug．Compared with the blank group,the expression of p53 mRNA and protein in the saponins group increased,while the expression of SLC7A11,GPX4 mRNA and protein decreased．The expression of p53 mRNA and protein in the saponins + inhibitor group was lower than that in the saponins group,while the expression levels of SLC7A11,GPX4 mRNA and protein increased．Conclusions PPI can effectively inhibit the proliferation of K562 cells and promote ferroptosis in K562 cells．The molecular mechanism can be related to the regulation of p53 signal pathway．

目的本文聚焦DeepSeek这一国产人工智能技术,结合护理临床实践,系统探讨其在护理场景中的应用潜力、现存问题及应对策略。方法检索国内外相关文献,与现有通用人工智能技术对比,进行综述,并提出思考和建议。结果预计DeepSeek在护理文书自动化、个性化护理方案生成、临床决策支持、护理质控及教育培训等提供适配应用路径,针对性的服务和解决方案等。结论DeepSeek可通过多模态技术整合与跨平台互补策略,推动护理服务向智能化、精准化方向发展,为缓解护理人力短缺、优化资源分配提供新思路。

ObjectiveThis study focuses on DeepSeek,a domestic artificial intelligence technology,systematically exploring its application potential,existing issues,and targeted strategies in nursing clinical scenarios through integration with practical nursing care contexts．MethodsRelevant literatures from both domestic and international sources were collected,compared with existing Artificial General Intelligence（AGI）technologies,to conduct a review,and propose reflections and recommendations．ResultsThrough literature review and technical comparisons,the results proposed specific application paths for DeepSeek in scenarios such as automated nursing documentation,personalized care plan generation,clinical decision support,quality control,and education．It further addressed issues including data privacy,ethical risks,and technical limitations．ConclusionsThe findings suggest that DeepSeek can integrate multimodal technologies and cross-platform complementary strategies to promote intelligent and precise nursing services,offering innovative solutions to alleviate nursing shortages and optimize resource allocation．

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（χ²=4.710,P=0.030;χ²=6.790,P=0.009;χ²=17.740,P<0.001;χ²=4.350,P=0.037;χ²=13.100,P<0.001;χ²=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（χ²=4.160,P=0.041;χ²=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 allergy（26.00% vs 7.00%）and other allergies（10.00 % vs 2.00%）were significantly different（χ²=4.710,P=0.030;χ²=6.790,P=0.009;χ²=17.740,P<0.001;χ²=4.350,P=0.037;χ²=13.100,P<0.001;χ²=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（χ²=4.160,P=0.041;χ²=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．