接受肺血管造影的患者在使用非离子型造影剂后血浆纤溶酶原激活物抑制剂-1（PAI-1）水平升高。
Increased plasma levels of PAI-1 after administration of nonionic contrast medium in patients undergoing pulmonary angiography.
作者信息
Van Beek E J, Levi M, Reekers J A, Hack C E, Büller H R, ten Cate J W
机构信息
Centre for Hemostasis, Thrombosis, Atherosclerosis, and Inflammation Research, Academic Medical Centre, University of Amsterdam, The Netherlands.
出版信息
Radiology. 1994 Dec;193(3):821-3. doi: 10.1148/radiology.193.3.7972831.
PURPOSE
To compare the effects of ionic and nonionic contrast media on markers of the coagulation, fibrinolytic, and contact systems.
MATERIALS AND METHODS
Low-osmolar ionic (ioxaglate) or nonionic (iohexol) contrast material was administered to 14 patients undergoing pulmonary angiography for suspected pulmonary embolism. Blood samples were obtained before and after the procedure and were analyzed for fibrinolysis and coagulation indicators such as plasminogen activator type 1 (PAI-1) activity, thrombin-antithrombin III (TAT) complexes, and platelet activation.
RESULTS
Both contrast agents caused a significant increase in TAT complexes. PAI-1 levels increased significantly in patients who received iohexol but not in those who received ioxaglate. Platelet activation was more pronounced in patients who received iohexol.
CONCLUSION
The increase in PAI-1 levels in response to iohexol may explain clinical differences in postprocedural thrombogenicity in patients who undergo angiography.
目的
比较离子型和非离子型造影剂对凝血、纤维蛋白溶解和接触系统标志物的影响。
材料与方法
对14例因疑似肺栓塞而行肺血管造影的患者给予低渗离子型（碘克沙醇）或非离子型（碘海醇）造影剂。在检查前后采集血样，并分析纤维蛋白溶解和凝血指标，如1型纤溶酶原激活物（PAI-1）活性、凝血酶-抗凝血酶III（TAT）复合物和血小板活化情况。
结果
两种造影剂均导致TAT复合物显著增加。接受碘海醇的患者PAI-1水平显著升高，而接受碘克沙醇的患者则未升高。接受碘海醇的患者血小板活化更为明显。
结论
碘海醇导致的PAI-1水平升高可能解释了血管造影术后患者血栓形成性的临床差异。
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