Murakami R, Tajima H, Kumazaki T, Yamamoto K
Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan.
Acta Radiol. 1998 Jul;39(4):368-71. doi: 10.1080/02841859809172446.
To investigate the acute renal effects of three contrast media in a double-blind randomized parallel-group study. The contrast media investigated were: the nonionic dimeric iso-osmolality medium iodixanol; the nonionic monomeric medium iomeprol; and the ionic dimeric medium ioxaglate.
A total of 30 patients were given the following doses of contrast medium: 10 patients received iodixanol 320 mg I/ml; 10 received iomeprol 300 mg I/ml; and 10 received ioxaglate 320 mg I/ml. The doses were given intra-arterially at routine abdominal angiography and the renal effects of these three contrast media were studied for up to 120 min after injection.
The urinary minute volume increased immediately after angiography but tended to return to baseline values after 120 min; these changes were more pronounced with iomeprol and ioxaglate than with iodixanol. Creatinine clearance was not reduced by any of the contrast media. Fraction excretion of sodium increased immediately and lasted for 30 min after angiography; these changes were more pronounced with ioxaglate than with iomeprol and iodixanol. Urinary gamma-glutamyl transferase increased for 120 min after angiography with iodixanol and iomeprol; these changes were more pronounced with iomeprol than with iodixanol. On the other hand, urinary nu-acetyl-beta-glucosaminidase increased for 120 min after angiography with iomeprol, but was unchanged with iodixanol.
The use of contrast media induces osmotic diuresis and its acute effects on the proximal tubular function. However, the iso-osmolality medium iodixanol induces fewer changes than the other two media.
在一项双盲随机平行组研究中，探究三种造影剂对肾脏的急性影响。所研究的造影剂分别为：非离子二聚体等渗造影剂碘克沙醇；非离子单体造影剂碘美普尔；离子二聚体造影剂碘克酸。
总共30例患者接受了以下剂量的造影剂：10例患者接受320mg I/ml的碘克沙醇；10例接受300mg I/ml的碘美普尔；10例接受320mg I/ml的碘克酸。在常规腹部血管造影时经动脉给予这些剂量，并在注射后长达120分钟内研究这三种造影剂对肾脏的影响。
血管造影后即刻尿每分钟尿量增加，但120分钟后趋于恢复至基线值；碘美普尔和碘克酸引起的这些变化比碘克沙醇更明显。三种造影剂均未降低肌酐清除率。血管造影后即刻钠排泄分数增加，并持续30分钟；碘克酸引起的这些变化比碘美普尔和碘克沙醇更明显。碘克沙醇和碘美普尔造影后120分钟内尿γ-谷氨酰转移酶升高；碘美普尔引起的这些变化比碘克沙醇更明显。另一方面，碘美普尔造影后120分钟内尿N-乙酰-β-氨基葡萄糖苷酶升高，但碘克沙醇造影后该酶无变化。
使用造影剂会引起渗透性利尿及其对近端肾小管功能的急性影响。然而，与其他两种造影剂相比，等渗造影剂碘克沙醇引起的变化较少。
