Bach R, Jung F, Scheller B, Hummel B, Ozbek C, Spitzer S, Schieffer H
Cardiac Out-Patient Centre, Dresden, University Hospital of Saarland, Germany.
Acta Radiol. 1996 Mar;37(2):214-7. doi: 10.1177/02841851960371P144.
PURPOSE, MATERIAL AND METHODS: Microcirculatory disturbances may be responsible for some of the adverse effects induced by contrast media. The influence of iopromide 370 (Ultravist) on cutaneous microcirculation was therefore investigated in 15 patients in a prospective study. Twenty ml of iopromide and 20 ml 0.9% NaCl were injected as reference in the subclavian artery at the beginning of a diagnostic coronary angiography. Erythrocyte velocity was measured in ipsilateral nailfold capillaries at the beginning of, during, and after the injection continuously up to 6 min after injection.
On average, 30 s after injection of contrast medium, erythrocyte velocity decreased significantly by 51.3% (p<0.0001) and remained reduced up to 120 s. This reaction was observed in 14 out of 15 patients. Three patients showed a temporary cessation of capillary blood flow.
The adverse effects sometimes seen during coronary angiography can be explained if similar contrast medium induced microcirculatory disturbances in the myocardial vasculature.
目的、材料与方法:微循环紊乱可能是造影剂所致某些不良反应的原因。因此,在一项前瞻性研究中,对15例患者研究了碘普罗胺370(优维显)对皮肤微循环的影响。在诊断性冠状动脉造影开始时,将20毫升碘普罗胺和20毫升0.9%氯化钠作为对照注入锁骨下动脉。在注射开始时、注射期间以及注射后持续至注射后6分钟,连续测量同侧甲襞毛细血管中的红细胞速度。
平均而言,注射造影剂后30秒,红细胞速度显著下降51.3%(p<0.0001),并持续降低至120秒。15例患者中有14例出现此反应。3例患者出现毛细血管血流暂时停止。
如果在心肌血管系统中造影剂诱发类似的微循环紊乱,那么冠状动脉造影期间有时出现的不良反应就可以得到解释。