Lasser E C, Lyon S G
Department of Radiology, University of California, San Diego, La Jolla 92093.
Invest Radiol. 1990 Jun;25(6):698-702. doi: 10.1097/00004424-199006000-00014.
There is increasing evidence that activation of the plasma contact system that results in the production of bradykinin plays an important role in contrast material systemic reactions. The effects of bradykinin in anaphylaxis depend on its rate of destruction and its rate of production. The highest percentage of contrast material reactions occur after intravenous injections, and the major enzyme hydrolyzing bradykinin (kininase II; angiotensin-converting enzyme) is found on pulmonary vascular endothelial surfaces. The inhibitory effects of numerous ionic and nonionic contrast material solutions on the enzyme have been determined. Additionally, the role in this inhibition of the chelators found in all commercial contrast material vials has been studied. In vitro, all such preparations combined with their chelators inhibit angiotensin-converting enzyme. Whether this inhibition plays a role in vivo remains to be established.
越来越多的证据表明，导致缓激肽产生的血浆接触系统激活在造影剂全身反应中起重要作用。缓激肽在过敏反应中的作用取决于其破坏速率和产生速率。最高比例的造影剂反应发生在静脉注射后，而水解缓激肽的主要酶（激肽酶II；血管紧张素转换酶）存在于肺血管内皮表面。已经确定了多种离子型和非离子型造影剂溶液对该酶的抑制作用。此外，还研究了所有市售造影剂瓶中发现的螯合剂在这种抑制作用中的作用。在体外，所有这些制剂与其螯合剂结合都会抑制血管紧张素转换酶。这种抑制作用在体内是否起作用仍有待确定。
