Thomsen H S, Golman K, Hemmingsen L, Larsen S, Skaarup P
Department of Diagnostic Radiology, University of Copenhagen, Herlev, Denmark.
Acta Radiol. 1990 Jan;31(1):93-8.
Urine profiles (albumin, glucose, NAG, LDH, GGT and sodium) were followed for 9 days after intravenous injection of either diatrizoate, iohexol, or saline in 27 Wistar rats with nephrosis induced by Adriamycin 42 days before. Another 9 rats exposed to neither Adriamycin nor contrast media served as controls. None of the contrast media caused further increased albuminuria of significance, whereas both induced significantly increased excretion of all 5 tubular components. The excretion of NAG and sodium was significantly higher following diatrizoate than following iohexol. From 24 h post injection there was no significantly greater excretion of any of the components after either diatrizoate or iohexol than after saline among the rats given Adriamycin. At the end of day 9 after contrast medium injection neither serum sodium, potassium, glucose, urea, creatinine, nor albumin revealed any contrast media related changes. Kidney histology showed quantitatively larger lesions in kidneys exposed to Adriamycin and contrast media than in kidneys exposed to Adriamycin and saline. There were no differences between the two contrast media groups. It is thus concluded, that both high osmolar ionic and low osmolar non-ionic contrast media cause temporary tubular dysfunction but no further glomerular dysfunction in rats with nephrosis induced by Adriamycin. The histologic findings indicate that both media may worsen non-reversible renal lesions.
在42天前用阿霉素诱导肾病的27只Wistar大鼠中，静脉注射泛影葡胺、碘海醇或生理盐水后，连续9天跟踪尿液指标（白蛋白、葡萄糖、N-乙酰-β-D-氨基葡萄糖苷酶、乳酸脱氢酶、γ-谷氨酰转移酶和钠）。另外9只既未接触阿霉素也未接触造影剂的大鼠作为对照。两种造影剂均未导致具有显著意义的蛋白尿进一步增加，而两者均导致所有5种肾小管成分的排泄显著增加。泛影葡胺注射后N-乙酰-β-D-氨基葡萄糖苷酶和钠的排泄显著高于碘海醇注射后。在注射后24小时，给予阿霉素的大鼠中，泛影葡胺或碘海醇注射后任何成分的排泄均未显著高于生理盐水注射后。在注射造影剂后第9天结束时，血清钠、钾、葡萄糖、尿素、肌酐和白蛋白均未显示出任何与造影剂相关的变化。肾脏组织学显示，暴露于阿霉素和造影剂的肾脏中的病变在数量上大于暴露于阿霉素和生理盐水的肾脏。两种造影剂组之间没有差异。因此得出结论，高渗离子型和低渗非离子型造影剂均可导致由阿霉素诱导肾病的大鼠出现暂时性肾小管功能障碍，但不会导致进一步的肾小球功能障碍。组织学结果表明，两种造影剂均可使不可逆性肾损伤恶化。
