Hardeman M R, Goedhart P, Koen I Y
Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Invest Radiol. 1991 Sep;26(9):810-9. doi: 10.1097/00004424-199109000-00006.
The effects of three low-osmolar radiographic contrast media (CM)--two nonionic (iohexol, iopamidol) and one ionic (ioxaglate)--on red blood cell (RBC) morphology and aggregation behavior, as well as on blood and plasma viscosity, have been studied. Blood taken from normal, healthy individuals and from patients with uremia was investigated. The authors controlled for the effects of dilution, ionic and nonionic hyperosomolality, and specific chemotoxicity. With ioxaglate, the normal biconcave RBC morphology was fairly well maintained. Iohexol produced a mixture of more-or-less normal cells and echinocytes, while iopamidol yielded only echinocytes. Irregular RBC aggregates have been frequently associated with the presence of echinocyte morphology. In the case of ioxaglate, the capacity of normal blood for rouleaux formation was preserved. This appeared to be compatible with an only moderate decrease in low shear viscosity values. In comparison to the normal control group, RBCs from patients with uremia were clearly more sensitive for hyperosmolar stress. It can be concluded that, in contrast to the nonionic CM, the ionic dimeric compound ioxaglate seems to protect human RBCs against hyperosmolar stress by a mechanism unknown at the present.
研究了三种低渗放射造影剂（CM）——两种非离子型（碘海醇、碘帕醇）和一种离子型（碘克沙醇）——对红细胞（RBC）形态和聚集行为以及血液和血浆粘度的影响。对取自正常健康个体和尿毒症患者的血液进行了研究。作者控制了稀释、离子型和非离子型高渗性以及特定化学毒性的影响。使用碘克沙醇时，正常的双凹RBC形态得到了较好的维持。碘海醇产生了或多或少正常细胞和棘形红细胞的混合物，而碘帕醇只产生棘形红细胞。不规则的RBC聚集体常与棘形红细胞形态的存在有关。在碘克沙醇的情况下，正常血液形成缗钱状的能力得以保留。这似乎与低剪切粘度值仅适度降低相一致。与正常对照组相比，尿毒症患者的RBC对高渗应激明显更敏感。可以得出结论，与非离子型CM不同，离子型二聚体化合物碘克沙醇似乎通过目前未知的机制保护人类RBC免受高渗应激。
