Nguyen P, Jolly D, Devie B, Marcus C, Adjizian J C, Menanteau B, Potron G
Laboratoire central d'Hématologie, Centre Hospitalier Universitaire de Reims.
J Mal Vasc. 1991;16(1):53-7.
It has been suggested (Fisher and al., Rainiko and al.) that contrast media could interfere with a red blood cell aggregation, low-osmolarity and non ionic contrast media leading to red blood cell aggregates in vitro. Clinical significance of this phenomenon is not known. We have studied 21 consecutive patients admitted in X ray department for pyelography. Sodium and meglumine ioxitalamate (Telebrix 38 R; Guerbet) osmolarity 2 100 mOsm kg--viscosity 8.5 cp at 37 degrees C is used for contrast. Red blood cell aggregation is studied by erythraggregometer Sefam. Samples are collected before (T0), 10 and 30 minutes (T10, T30) after contrast infusion. Hemogram and coagulation parameters are measured in parallel. Results show a significant increase of aggregation times at T10, with a trend towards baseline at T30. Dissociation shear rates follow the same fluctuations. We note a concomitant diminution of both fibrinogen and hematocrit levels, well-correlated with red blood cell aggregation. These results suggest a process of hemodilution which could explain the diminution of red blood cell aggregation with this type of contrast medium.
有人提出（费舍尔等人、拉伊尼科等人），造影剂可能会干扰红细胞聚集，低渗和非离子型造影剂在体外会导致红细胞聚集。这种现象的临床意义尚不清楚。我们研究了21例连续入住X线科进行肾盂造影的患者。使用渗透压为2100mOsm/kg、37℃时粘度为8.5cp的碘他拉酸钠和葡甲胺（Telebrix 38R；盖博公司）作为造影剂。通过Sefam红细胞聚集仪研究红细胞聚集情况。在注入造影剂前（T0）、注入后10分钟和30分钟（T10、T30）采集样本。同时测量血常规和凝血参数。结果显示，T10时聚集时间显著增加，T30时有恢复至基线水平的趋势。解离切变率呈现相同的波动。我们注意到纤维蛋白原和血细胞比容水平同时降低，且与红细胞聚集密切相关。这些结果提示存在血液稀释过程，这可能解释了使用此类造影剂时红细胞聚集减少的现象。
