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| 瑞马唑仑相关过敏反应的研究进展 |
| Research progress in remimazolam-related hypersensitivity reactions |
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| DOI：10.12089/jca.2026.03.016 |
| 中文关键词: 瑞马唑仑 过敏反应 免疫球蛋白E |
| 英文关键词: Remimazolam Hypersensitivity reactions Immunoglobulin E |
| 基金项目:国家自然科学基金面上项目（82371241，82171232）；上海市优秀学术带头人计划（22XD1404900） |
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| 中文摘要: |
| 瑞马唑仑是一种新型超短效苯二氮类镇静药，具起效快、代谢快及血流动力学稳定等优势，但瑞马唑仑会诱导过敏反应，表现为皮疹、喉头水肿、低血压甚至过敏性休克，机制涉及免疫球蛋白E(IgE)介导和非IgE介导反应。诊断依赖临床表现、血清类胰蛋白酶检测、皮肤试验及药物激发试验。一旦发生过敏反应，应立即停药并根据具体病情予以肾上腺素、液体复苏及呼吸支持。临床应加强术前评估与风险防控，未来研究应聚焦机制解析和高风险人群识别，以提升安全用药水平。 |
| 英文摘要: |
| Remimazolam is a novel ultra-short-acting benzodiazepine sedative characterized by rapid onset, fast metabolism, and stable hemodynamic properties. However, it may induce hypersensitivity reactions, presenting as rash, laryngeal edema, hypotension, and even anaphylactic shock. The underlying mechanisms involve both immunoglobulin E (IgE)-mediated and non-IgE-mediated pathways. Diagnosis relies on clinical manifestations, serum tryptase testing, skin testing, and drug provocation tests. In the event of an allergic reaction, remimazolam should be immediately discontinued, and appropriate treatment, including epinephrine administration, fluid resuscitation, and respiratory support, which should be initiated based on the patient's condition. Preoperative risk assessment and preventive strategies should be emphasized in clinical practice. Future research should focus on elucidating underlying mechanisms and identifying high-risk populations to improve medication safety. |
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