Cumberland D C
Br Heart J. 1981 Jun;45(6):698-702. doi: 10.1136/hrt.45.6.698.
The hyperosmolality of current ionic angiographic media gives rise to several adverse effects. Use of the first low-osmolality medium, metrizamide (Amipaque), has been inhibited by expense and by the necessity for prior mixing into solution. Hexabrix is the first of such media to be available in stable solution, and its use in angiocardiography is reported, in direct comparison with Urografin, Triosil, Cardio-Conray, and metrizamide. The low osmolality media cause significantly less discomfort than ionic media, and are better tolerated in paediatric angiocardiography. In coronary angiography Hexabrix causes comparable T wave change to Urografin and more than Triosil or metrizamide, but tends to have less effect on heart rate. The risk of exacerbating pulmonary arterial hypertension in right heart angiography appears to be reduced.
目前离子型血管造影剂的高渗性会产生多种不良反应。第一种低渗性造影剂甲泛葡胺(阿米培克),由于价格昂贵以及需要预先混合成溶液而未得到广泛应用。六异泛影葡胺是第一种以稳定溶液形式供应的此类造影剂,本文报道了其在心血管造影中的应用,并与泛影葡胺、碘三醇、心可维显和甲泛葡胺进行了直接比较。低渗性造影剂引起的不适明显少于离子型造影剂,在儿科心血管造影中耐受性更好。在冠状动脉造影中,六异泛影葡胺引起的T波变化与泛影葡胺相当,比碘三醇或甲泛葡胺更明显,但对心率的影响较小。在右心造影中,加重肺动脉高压的风险似乎有所降低。