Murphy M E, Tublin M E, Li S
Department of Pharmacology, The Albany Medical Center, New York 12208, USA.
Invest Radiol. 1998 Jun;33(6):356-65. doi: 10.1097/00004424-199806000-00007.
Contrast media (CM) such as diatrizoate meglumine (DTZ) or iohexol can cause renal vasoconstriction in vivo, and this may initiate CM-induced nephropathy. Endothelin-1 (ET-1), a vasoconstrictor, and nitric oxide, a vasodilator, are key modulators of renal circulation. We tested the hypothesis that CM enhances arterial responses to ET-1, or diminishes responses to nitric oxide.
A video dimension analyzer continuously recorded changes in diameter of isolated, pressurized rat interlobar renal arteries (200-400 microm diameter) superfused with combinations of CM, ET-1, nitric oxide, and other vasoactive agents.
Superfusion of arteries with 3.3% DTZ, but not with 3.3% iohexol, enhanced their sensitivity to ET-1 by approximately twofold, as assessed by shifts in concentration-response curves. Both DTZ and iohexol decreased the sensitivity of arteries to nitric oxide by approximately threefold. Neither DTZ nor iohexol affected arterial sensitivity to other vasoconstrictors (phenylephrine, potassium) or vasodilators (forskolin, diltiazem).
Diatrizoate meglumine and iohexol may induce or augment renal vasoconstriction in part by causing selective alterations in arterial sensitivity to ET-1 and to nitric oxide.
诸如泛影葡胺（DTZ）或碘海醇等造影剂（CM）在体内可引起肾血管收缩，这可能引发造影剂所致肾病。内皮素-1（ET-1）是一种血管收缩剂，一氧化氮是一种血管舒张剂，它们是肾循环的关键调节因子。我们检验了造影剂增强动脉对ET-1的反应或减弱对一氧化氮反应的假说。
使用视频尺寸分析仪连续记录分离的、加压的大鼠叶间肾动脉（直径200 - 400微米）在灌注造影剂、ET-1、一氧化氮及其他血管活性药物组合时直径的变化。
用3.3%的DTZ灌注动脉，但用3.3%的碘海醇灌注时则不然，通过浓度 - 反应曲线的变化评估，动脉对ET-1的敏感性增强了约两倍。DTZ和碘海醇均使动脉对一氧化氮的敏感性降低了约三倍。DTZ和碘海醇均未影响动脉对其他血管收缩剂（去氧肾上腺素、钾）或血管舒张剂（福斯可林、地尔硫䓬）的敏感性。
泛影葡胺和碘海醇可能部分通过引起动脉对ET-1和一氧化氮敏感性的选择性改变而诱导或增强肾血管收缩。
