Rossi L, Spinetta G, Bergamaschi E, Mutti A, Rossi A, Alinovi R, Rossi G, Franchini I
Istituto di Radiologia, Università Parma.
Radiol Med. 1989 Dec;78(6):612-5.
The nephrotoxicity of ionic and nonionic contrast media (cm) was evaluated in 52 patients undergoing pyelography. The contrast media were i.v. injected in 30'. Urine samples were collected before, 2 and 48 hours after the injection. Urinary albumin (alb) and retinol binding protein (RBP) excretion was evaluated by immunoenzymatic methods; alb and RBP were considered as indicators of glomerular permeability and of tubular reabsorption, respectively. The urinary excretion of brush-border antigen of proximal tubule (BBA) was also measured, as an indicator of microtissue damage, by a sensitive double-antibody ELISA with monoclonal antibodies. The results demonstrate ionic cm to have greater functional effects than nonionic ones, as suggested by the increased urinary excretion of both alb and RBP. However, tubular damage seemed to be more severe with nonionic agents, as suggested by BBA excretion. Although toxic damage had little significance for the patients' health, long-term effects are not to be excluded.
在52例接受肾盂造影的患者中评估了离子型和非离子型造影剂的肾毒性。造影剂在30分钟内静脉注射。在注射前、注射后2小时和48小时采集尿液样本。采用免疫酶法评估尿白蛋白（alb）和视黄醇结合蛋白（RBP）排泄；alb和RBP分别被视为肾小球通透性和肾小管重吸收的指标。还通过使用单克隆抗体的灵敏双抗体ELISA法测量近端小管刷状缘抗原（BBA）的尿排泄，作为微组织损伤的指标。结果表明，如alb和RBP尿排泄增加所示，离子型造影剂比非离子型造影剂具有更大的功能影响。然而，如BBA排泄所示，非离子型造影剂引起的肾小管损伤似乎更严重。尽管毒性损伤对患者健康影响不大，但不能排除长期影响。
