Cavalli F, Mucci M P, Cociancich L, Micheli W, Bacarini L, Cisternino M
Servizio Ospedaliero di Radiologia, Ospedale Maggiore, Trieste.
Radiol Med. 1987 Dec;74(6):512-5.
RCM have been observed to cause--during arthrography--the appearance of a slow onset painful symptomatology with the clinical characteristics of a slight and transient acute arthritis. These substances are supposed to set in a production of humoral mediators of inflammation with algogenic action--PGE2 in particular. During arthrography of the knee the release of synovial fluid PGE2 after RCM introduction was studied. Two RCM were compared: meglumine iothalamate and iopamidol. Twenty patients underwent arthrography of the knee: synovial fluid PGE2 concentration was measured both before and 15' after RCM introduction with 125I-RIA method. Results show a significant increase in PGE2 concentration after both iothalamate (p less than 0.0001) and iopamidol (p less than 0.01) --especially in iothalamate--treated patients (p less than 0.01). A physiopathologic mechanism about post-arthrographic pain and, more generally, about RCM toxicity is thus hypothesized.
已观察到，在关节造影期间，造影剂会引发起病缓慢的疼痛症状，其临床特征为轻微且短暂的急性关节炎。这些物质被认为会引发具有致痛作用的炎症体液介质的产生，尤其是前列腺素E2（PGE2）。在膝关节造影过程中，研究了注入造影剂后滑液中PGE2的释放情况。比较了两种造影剂：碘他拉葡胺和碘帕醇。20例患者接受了膝关节造影：采用125I - RIA法在注入造影剂前及注入后15分钟测量滑液中PGE2的浓度。结果显示，碘他拉葡胺组（p < 0.0001）和碘帕醇组（p < 0.01）患者注入造影剂后PGE2浓度均显著升高，碘他拉葡胺组尤为明显（p < 0.01）。由此推测了关节造影后疼痛以及更普遍的造影剂毒性的病理生理机制。
