Higashi S, Yasukochi H, Ishioka K, Sugiyama T, Narasaki K
Department of Radiology, Teikyo University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 1994 Jul 25;54(8):725-36.
This study was carried out in order to clarify the effects of rapid intravenous urography performed twice at a three-day interval with contrast medium on renal function and morphologic change in normal rabbits as a means to observe progress or to reexamine patients. The ionic high-osmolal amidotrizoate, non-ionic low-osmolal iopamidol, and ionic low-osmolal ioxaglate were used. A second urography was performed and curves of kidney density plotted against time and nephrograms were obtained. Serum BUN and creatinine were measured, and the kidneys were removed for histologic observations. Following amidotrizoate administration, curves of kidney density showed significantly slower clearance than with iopamidol and ioxaglate. Nephrograms at 40 seconds showed that opacification of the renal pelvis and urinary tracts also was poor. Serum creatinine following the second administration of amidotrizoate was significantly higher than the values before and at the first urography, and both serum BUN and creatinine were significantly higher than they were after iopamidol and ioxaglate. Although light microscopic changes were obscure, marked changes were observed by electron microscopy. In conclusion, intravenous urography conducted twice at a close interval with amidotrizoate induces impairment of glomerular function and morphologic change.
本研究旨在阐明间隔三天两次快速静脉肾盂造影使用造影剂对正常家兔肾功能和形态学变化的影响,以此作为观察病情进展或对患者进行复查的一种手段。使用了离子型高渗泛影葡胺、非离子型低渗碘帕醇和离子型低渗碘克沙醇。进行了第二次肾盂造影,绘制了肾脏密度随时间变化的曲线并获得了肾图。测定了血清尿素氮和肌酐,并取出肾脏进行组织学观察。给予泛影葡胺后,肾脏密度曲线显示清除速度明显慢于碘帕醇和碘克沙醇。40秒时的肾图显示肾盂和尿路的显影也较差。第二次给予泛影葡胺后的血清肌酐明显高于第一次肾盂造影前及造影时的值,血清尿素氮和肌酐均明显高于给予碘帕醇和碘克沙醇后的值。虽然光镜下变化不明显,但电镜下观察到明显变化。总之,短期内两次使用泛影葡胺进行静脉肾盂造影会导致肾小球功能损害和形态学改变。