Idée J M, Lancelot E, Berthommier C, Couturier-Goulas V, Vazin V, Corot C
Laboratoire Guerbet, Biology Department, Roissy-Charles de Gaulle, France.
Fundam Clin Pharmacol. 2000 Jan-Feb;14(1):11-8. doi: 10.1111/j.1472-8206.2000.tb00388.x.
Non-ionic dimeric contrast media (CM) are a new class of CM which are iso-osmolar with plasma. The aim of this study was to investigate their effects on systemic and renal haemodynamics. The non-ionic dimeric CM iodixanol and the non-ionic monomeric agent iobitridol (both at a dose of 1,600 mgI/kg) were compared in terms of their effects on systemic blood pressure (BP) and renal blood flow (RBF) in two strains of rats (Wistar and Sprague Dawley). Iodixanol significantly lowered BP in Wistar rats (-33 +/- 9% of baseline, 10 min post-injection, P < 0.001 vs. saline and iobitridol). Iobitridol had virtually no effect on BP. Iobitridol and iodixanol significantly decreased RBF. This effect was more marked following injection of the dimer rather than the monomer (iodixanol: -32 +/- 13% iobitridol: -20 +/- 4 of baseline at 16 min, P < 0.05). For both agents, RBF was still decreased 50 min following injection (iodixanol: -30 +/- 11%, and iobitridol: -20 +/- 5% of baseline). Iodixanol also decreased RBF in Sprague Dawley rats, while BP remained unchanged. This suggests that changes in BP/RBF autoregulation do not account for the renal haemodynamic effects of this agent. When measured 2 h following injection, the iodixanol-induced renal hypoperfusion was still detectable (-29% vs. saline-treated rats), although not significant (P = 0.06). This effect was no longer observed 4 h following injection. Increasing the saline infusion rate (18 mL/h vs. 2 mL/h) during the experiment did not significantly decrease the effects of iodixanol on BP and RBF in Wistar rats. In spite of its iso-osmolality, iodixanol, a non-ionic dimeric CM, depressed RBF and BP significantly more than iobitridol, a monomeric non-ionic agent, in Wistar rats. This effect was long-lasting and was not alleviated by increasing the hydration rate.
非离子二聚体造影剂（CM）是一类新型造影剂，与血浆等渗。本研究旨在探讨其对全身和肾脏血流动力学的影响。比较了非离子二聚体造影剂碘克沙醇和非离子单体造影剂碘比醇（剂量均为1600 mgI/kg）对两种品系大鼠（Wistar和Sprague Dawley）的全身血压（BP）和肾血流量（RBF）的影响。碘克沙醇显著降低了Wistar大鼠的血压（注射后10分钟，较基线降低-33±9%，与生理盐水和碘比醇相比，P<0.001）。碘比醇对血压几乎没有影响。碘比醇和碘克沙醇均显著降低了肾血流量。注射二聚体而非单体后，这种作用更为明显（碘克沙醇：16分钟时较基线降低-32±13%，碘比醇：-20±4%，P<0.05）。对于两种药物，注射后50分钟肾血流量仍降低（碘克沙醇：-30±11%，碘比醇：-20±5%较基线）。碘克沙醇也降低了Sprague Dawley大鼠的肾血流量，而血压保持不变。这表明血压/肾血流量自身调节的变化不能解释该药物对肾脏血流动力学的影响。注射后2小时测量时，碘克沙醇诱导的肾脏灌注不足仍可检测到（与生理盐水处理的大鼠相比为-29%），尽管不显著（P=0.06）。注射后4小时不再观察到这种作用。实验期间增加生理盐水输注速率（18 mL/h vs. 2 mL/h）并未显著降低碘克沙醇对Wistar大鼠血压和肾血流量的影响。尽管碘克沙醇具有等渗性，但在Wistar大鼠中，作为非离子二聚体造影剂的碘克沙醇比作为非离子单体造影剂的碘比醇更显著地降低肾血流量和血压。这种作用持续时间长，且不会因增加补液速率而减轻。
