Turnheim K
Wien Klin Wochenschr. 1986 May 30;98(11):333-8.
The non-ionic X-ray contrast media metrizamide, iopamidol, iohexol, and iopromide do not bind calcium and are less hyperosmolar than the conventional ionic contrast media, for instance amidotrizoate (diatrizoate), iothalamate, or ioglicate. Hence the use of non-ionic contrast media is associated with less undesirable side-effects that are attributable to hypertonicity such as an increase in circulating plasma volume, decreased deformability of red blood cells, damage of vascular endothelium with consequent activation of blood coagulation, the complement system and fibrinolysis, increased release of bradykinin and histamine, cardiac arrhythmias, diuresis, vasodilation and decreased blood pressure, pain and heat sensation. Because of less dilution the quality of imaging is also better. According to the intravenous LD50 in experimental animals the acute toxicity of non-ionic contrast media is lower than that of ionic media. With respect to contrast quality and the rate of side-effects the various non-ionic contrast media appear to be equivalent. Despite their higher price and higher viscosity it is probable that the non-ionic contrast media will replace the classical ionic media, especially in angio- and myelography.
非离子型X射线造影剂甲泛葡胺、碘帕醇、碘海醇和碘普罗胺不与钙结合，且其高渗性低于传统的离子型造影剂，例如泛影酸盐（泛影葡胺）、碘他拉酸盐或碘克沙酸盐。因此，使用非离子型造影剂所产生的不良副作用较少，这些副作用归因于高渗性，如循环血浆量增加、红细胞变形性降低、血管内皮损伤继而激活凝血、补体系统和纤维蛋白溶解、缓激肽和组胺释放增加、心律失常、利尿、血管舒张和血压降低、疼痛和热感。由于稀释较少，成像质量也更好。根据实验动物的静脉半数致死量，非离子型造影剂的急性毒性低于离子型造影剂。就造影质量和副作用发生率而言，各种非离子型造影剂似乎相当。尽管非离子型造影剂价格较高且粘度较大，但它们很可能会取代传统的离子型造影剂，尤其是在血管造影和脊髓造影中。
