Schräder R, Geigle P, Lemperle M, Fischer H, Kober G, Kaltenbach M
Abteilung für Kardiologie, Universität Frankfurt/Main.
Dtsch Med Wochenschr. 1991 Dec 20;116(51-52):1937-42. doi: 10.1055/s-2008-1063842.
Changes in blood and plasma volumes were investigated in the course of diagnostic cardiac catheterizations, comparing the effect of a high and a low osmolar contrast medium in 30 patients (5 women and 25 men; mean age 53 [19-76] years) with coronary heart disease (n = 27) or valvular defect (n = 3). Using a randomized, double-blind protocol 15 patients received amidotrizoic acid (2.1 osmol/kg; mean dosage 166 +/- 68 or 2.2 +/- 1.1 ml/kg), while 15 patients received iopamidol (0.8 osmol/kg; mean dosage 154 +/- 78 ml or 2.1 +/- 1.0 ml/kg). The indocyanine-green method and the haematocrit were used to measure blood and plasma volumes immediately before and after the angiocardiography. Blood volume after amidotrizoic acid injection increased by a mean of 4.9% (228 +/- 242 ml) and by 0.4% (17 +/- 197 ml) after iopamidol (P less than 0.05). Plasma volume increased by a mean of 11.8% (331 +/- 150 ml) after amidotrizoic acid and 5.7% (157 +/- 97 ml) after iopamidol (P less than 0.01). The increase in plasma volume correlated with the dose of contrast medium: 2 ml per ml amidotrizoic acid (r = 0.93) and 1 ml per ml iopamidol (r = 0.82).--During angiocardiography blood and plasma volume may increase by up to 500 ml, an increase which depends not only on dosage but also on the osmolality of the injected contrast medium.
在诊断性心导管插入术过程中，对30例（5例女性和25例男性；平均年龄53[19 - 76]岁）冠心病患者（n = 27）或瓣膜缺损患者（n = 3）的血容量和血浆容量变化进行了研究，比较了高渗和低渗造影剂的效果。采用随机双盲方案，15例患者接受泛影酸（2.1渗透压摩尔/千克；平均剂量166±68或2.2±1.1毫升/千克），而15例患者接受碘帕醇（0.8渗透压摩尔/千克；平均剂量154±78毫升或2.1±1.0毫升/千克）。在心血管造影术前和术后立即使用吲哚菁绿法和血细胞比容来测量血容量和血浆容量。注射泛影酸后血容量平均增加4.9%（228±242毫升），注射碘帕醇后增加0.4%（17±197毫升）（P<0.05）。注射泛影酸后血浆容量平均增加11.8%（331±150毫升），注射碘帕醇后增加5.7%（157±97毫升）（P<0.01）。血浆容量的增加与造影剂剂量相关：泛影酸每毫升2毫升（r = 0.93），碘帕醇每毫升1毫升（r = 0.82）。——在心血管造影术期间，血容量和血浆容量可能增加多达500毫升，这种增加不仅取决于剂量，还取决于注入造影剂的渗透压。
