Albert J P, Bernsmeier R, Bruhn H D
Med Klin. 1979 Nov 30;74(48):1811-7.
The intravenous application of x-ray contrast media during arteriographies resulted in a small, statistically significant, however clinically and biologically not relevant prolongation of the thromboplastin time and of the thrombincoagulase time. Contrast media applied for the examination of the kidneys and of the gall bladder did not induce any comparable changes of coagulation parameters. In vitro addition of iodinated contrast media to citrated plasmas was inhibitory to the coagulation process. Further analysis demonstrated that contrast media did not influence coagulation by enzyme inhibition but by inhibition of fibrin polymerization. Euglobulin lysis time was not only shortened by diagnostic applications of contrast media but also by other diagnostic procedures (gastroscopies, rectoscopies, laparoscopies) which involved physical exercise and thereby activation of the fibrinolytic system. Finally it is discussed that thrombotic complications following angiographies might be induced by the punction and injury of the vessel with the liberation of thrombokinase and subendothelial collagen.
动脉造影术中静脉注射X射线造影剂会导致凝血活酶时间和凝血酶 - 凝固酶时间出现轻微延长，在统计学上具有显著意义，但在临床和生物学上并无相关性。用于肾脏和胆囊检查的造影剂并未引起凝血参数的任何类似变化。在体外向枸橼酸化血浆中添加碘化造影剂会抑制凝血过程。进一步分析表明，造影剂不是通过抑制酶来影响凝血，而是通过抑制纤维蛋白聚合来影响凝血。优球蛋白溶解时间不仅会因造影剂的诊断应用而缩短，还会因其他涉及体育活动从而激活纤维蛋白溶解系统的诊断程序（胃镜检查、直肠镜检查、腹腔镜检查）而缩短。最后讨论了血管造影术后的血栓并发症可能是由穿刺和血管损伤导致血栓激酶和内皮下胶原释放所引起的。
