Gomi N
Department of Radiology, Tokyo Medical and Dental University, Faculty of Medicine, Japan.
Br J Radiol. 1992 Nov;65(779):961-7. doi: 10.1259/0007-1285-65-779-961.
To study the mechanism of the pain produced by contrast media (CM) in peripheral arteriography, we examined the direct effects of low concentrations (1.85-100 mg I/ml) of CM (diatrizoate, iopamidol, ioxaglate, and iotrolan) on helically cut strips of canine blood vessels taken from six different regions. We found that: (a) low concentrations of CM induced vasoconstriction. (b) This occurred immediately after the application of CM and produced sustained constriction. (c) The constriction produced in arteries was dose-dependent. (d) The production and intensity of constriction in the arterial strips differed as follows: cranial mesenteric artery > renal artery > femoral artery > common carotid artery > thoracic aorta > coronary artery. The effects of the CM were, in order of magnitude: diatrizoate > iopamidol > ioxaglate > iotrolan. Differences between CM corresponded with the differences in osmolality of the CM solutions. (e) Low concentrations of meglumine and mannitol also produced vasoconstriction. (f) Constriction caused by all drug samples used was reversible, but the process of relaxation to the original tension was much slower in CM-treated arterial strips than in the other strips. From these results, we confirmed that the incidence and degree of vasoconstriction produced by all drug samples used in this experiment depended on solution osmolality, rather than on chemotoxicity or ionicity. We discuss the physiological mechanism of these results and stress the importance of CM hyperosmolality in vasoconstriction and vascular pain production.
为研究外周血管造影术中造影剂(CM)所致疼痛的机制,我们检测了低浓度(1.85 - 100 mg I/ml)的CM(泛影葡胺、碘帕醇、碘克沙醇和碘曲仑)对取自犬类六个不同区域的螺旋形血管条的直接作用。我们发现:(a)低浓度的CM可引起血管收缩。(b)CM应用后立即出现这种情况,并产生持续性收缩。(c)动脉中产生的收缩具有剂量依赖性。(d)动脉条中收缩的产生和强度如下:肠系膜上动脉>肾动脉>股动脉>颈总动脉>胸主动脉>冠状动脉。CM的作用强度依次为:泛影葡胺>碘帕醇>碘克沙醇>碘曲仑。CM之间的差异与CM溶液的渗透压差异相对应。(e)低浓度的葡甲胺和甘露醇也可引起血管收缩。(f)所有使用的药物样本引起的收缩都是可逆的,但CM处理的动脉条恢复到原始张力的松弛过程比其他条慢得多。从这些结果来看,我们证实本实验中使用的所有药物样本所产生的血管收缩的发生率和程度取决于溶液渗透压,而非化学毒性或离子性。我们讨论了这些结果的生理机制,并强调了CM高渗在血管收缩和血管疼痛产生中的重要性。