Brogan W C, Hillis L D, Lange R A
Department of Internal Medicine (Cardiovascular Division), University of Texas Southwestern Medical Center, Dallas 75235.
Am Heart J. 1991 Oct;122(4 Pt 1):1129-35. doi: 10.1016/0002-8703(91)90481-v.
Ionic and nonionic contrast materials are similarly efficacious in providing excellent images with minimal risk to the patient. In comparison with ionic media, the nonionic agents produce minor alterations in intracardiac and peripheral pressures as well as in electrocardiographic intervals and morphology. In addition, nonionic media are less often associated with undesirable symptoms, such as flushing and vomiting. At the same time, ionic and nonionic media are accompanied by a similar incidence of nephrotoxicity, serious arrhythmias, and death. Finally, nonionic contrast material is substantially more expensive than ionic media. In light of this marked difference in cost, one could argue that nonionic media should be reserved for "high-risk" patients, that is, those with a history of a serious adverse reaction to ionic contrast media and those in whom contrast-induced hypotension would be particularly deleterious.
离子型和非离子型造影剂在为患者提供优质影像且风险最小化方面同样有效。与离子型造影剂相比，非离子型造影剂对心内和外周压力以及心电图间期和形态产生的影响较小。此外，非离子型造影剂较少引发诸如潮红和呕吐等不良症状。同时，离子型和非离子型造影剂伴随肾毒性、严重心律失常和死亡的发生率相似。最后，非离子型造影剂比离子型造影剂贵得多。鉴于成本上的显著差异，有人可能会认为非离子型造影剂应保留给“高危”患者，即那些对离子型造影剂有严重不良反应史的患者以及造影剂诱发的低血压可能特别有害的患者。
