Schräder R
Cardioangiologisches Centrum Bethamien, Frankfurt am Main, Germany.
Eur J Radiol. 1996 Nov;23 Suppl 1:S10-3. doi: 10.1016/s0720-048x(96)01096-1.
The role of contrast media in determining the occurrence of thromboembolic complications is not easy to define. Contrast media have a series of effects on blood constituents and on the hemostatic system. As for in vitro studies, it is generally agreed that ionic contrast media are stronger anticoagulants than nonionic, this being due to the fact that nonionic media are more inert on biological systems. This has been confirmed also in a recent paper comparing a nonionic monomer (iopamidol) with an ionic monomer (diatrizoate) and an ionic dimer (ioxaglate). Clinical data failed to demonstrate a greater thrombogenicity of one class of contrast media with respect to the other. The occurrence of thromboembolic complications in coronary angiography and PTCA is mostly related to operator experience and type of angiographic procedure.
造影剂在确定血栓栓塞并发症发生情况方面的作用并不容易界定。造影剂对血液成分和止血系统有一系列影响。至于体外研究，人们普遍认为离子型造影剂比非离子型造影剂具有更强的抗凝作用，这是因为非离子型造影剂在生物系统上更具惰性。这一点在最近一篇比较非离子单体（碘帕醇）与离子单体（泛影酸盐）和离子二聚体（碘克沙醇）的论文中也得到了证实。临床数据未能表明一类造影剂相对于另一类造影剂具有更高的血栓形成性。冠状动脉造影和经皮冠状动脉腔内血管成形术中血栓栓塞并发症的发生主要与操作者经验和血管造影程序类型有关。
