Szolar D H, Saeed M, Flueckiger F, Preidler K, Stiskal M A, Watzinger N, Sternthal H, Horina J
Department of Radiology, University of California, San Francisco 94143-0628, USA.
Invest Radiol. 1995 Mar;30(3):144-9. doi: 10.1097/00004424-199503000-00002.
Little information is available about the direct action of angiographic contrast media on vasoactive peptides and allergy-mediated substances in humans. This study defined the acute effects of iopromide, a nonionic contrast medium (370 mg/mL iodine), on vasoactive peptides, allergy-mediated substances, and hemodynamic parameters in healthy volunteers.
Pulmonary digital subtraction angiography was performed in seven healthy volunteers with no cardiovascular or pulmonary disease. Iopromide was administered as a total volume of 100 mL through a 7-Fr catheter inserted in the right femoral vein. The injected volumes and duration of injection (15-20 mL/second) were kept constant. The following hemodynamic parameters were monitored continuously: results of electrocardiogram, heart rate, and phasic and mean pulmonary arterial and peripheral arterial pressures. Blood samples were obtained before and 3 to 5 minutes after injection of contrast media to determine the concentrations of the following vasoactive peptides: renin, angiotensin I-converting enzyme, angiotensin II, aldosterone, atrial natriuretic peptide, antidiuretic hormone, cyclic guanosine monophosphate, and myoglobin; and to allergy-mediated substances such as tryptase, eosinophil protein X, and eosinophil cationic protein, using radioimmunoassay techniques.
Iopromide substantially increased atrial natriuretic peptide (48.8 +/- 8.9 to 85.8 +/- 13.0) and antidiuretic hormone (3.4 +/- 0.3 to 4.6 +/- 0.5) levels, whereas renin decreased (0.9 +/- 0.1 to 0.8 +/- 0.2) slightly but not significantly. Iopromide did not induce substantial changes in the other vasoactive peptides or in allergy-mediated substances after the contrast medium was injected. Similarly, cardiovascular parameters (heart rate, pulmonary and systemic blood pressures, and results of electrocardiogram) also remained unchanged after contrast injection.
Iopromide caused no appreciable hemodynamic alterations associated with the changes in atrial natriuretic peptide and antidiuretic hormone and no evidence of allergy-mediated reactions in all volunteers.
关于血管造影剂对人体血管活性肽和过敏介导物质的直接作用，目前所知甚少。本研究确定了非离子型造影剂碘普罗胺（370mg/mL碘）对健康志愿者血管活性肽、过敏介导物质及血流动力学参数的急性影响。
对7名无心血管或肺部疾病的健康志愿者进行肺部数字减影血管造影。通过插入右股静脉的7F导管给予总量为100mL的碘普罗胺。注射体积和注射持续时间（15 - 20mL/秒）保持恒定。连续监测以下血流动力学参数：心电图结果、心率、肺动脉和外周动脉的相位及平均压力。在注射造影剂前及注射后3至5分钟采集血样，以测定以下血管活性肽的浓度：肾素、血管紧张素I转换酶、血管紧张素II、醛固酮、心房利钠肽、抗利尿激素、环磷酸鸟苷和肌红蛋白；并使用放射免疫分析技术测定过敏介导物质，如类胰蛋白酶、嗜酸性粒细胞蛋白X和嗜酸性粒细胞阳离子蛋白。
碘普罗胺使心房利钠肽水平大幅升高（从48.8±8.9升至85.8±13.0），抗利尿激素水平升高（从3.4±0.3升至4.6±0.5），而肾素略有下降（从0.9±0.1降至0.8±0.2），但无显著差异。注射造影剂后，碘普罗胺未引起其他血管活性肽或过敏介导物质的显著变化。同样，注射造影剂后心血管参数（心率、肺和体循环血压以及心电图结果）也保持不变。
在所有志愿者中，碘普罗胺未引起与心房利钠肽和抗利尿激素变化相关的明显血流动力学改变，也未出现过敏介导反应的证据。
