Morcos S K, Dawson P, Pearson J D, Jeremy J Y, Davenport A P, Yates M S, Tirone P, Cipolla P, de Haën C, Muschick P, Krause W, Refsum H, Emery C J, Liss P, Nygren A, Haylor J, Pugh N D, Karlsson J O
Department of Diagnostic Imaging, Northern General Hospital NHS Trust, Sheffield, UK.
Eur J Radiol. 1998 Nov;29(1):31-46. doi: 10.1016/s0720-048x(98)00018-7.
All classes of iodinated water-soluble radiographic contrast media (RCM) are vasoactive with the iso-osmolar dimers inducing the least changes in the vascular tone. The mechanisms responsible for RCM-induced changes in the vascular tone are not fully understood and could be multifactorial. A direct effect on the vascular smooth muscle cells causing alterations in the ion exchanges across the cell membrane is thought to be an important factor in RCM-induced vasodilatation. The release of the endogenous vasoactive mediators adenosine and endothelin may also play a crucial role in the haemodynamic effects of RCM particularly in the kidney. In addition, the effects of RCM on blood rheology can cause a reduction in the blood flow in the microcirculation. The purpose of this review is to discuss the pathophysiology of the haemodynamic effects of RCM and to offer some insight into the biology of the endothelium and vascular smooth muscle cells as well as the pharmacology of the important vasoactive mediators endothelin and adenosine.
所有种类的碘化水溶性放射造影剂（RCM）都具有血管活性，其中等渗二聚体引起的血管张力变化最小。RCM引起血管张力变化的机制尚未完全明确，可能是多因素的。对血管平滑肌细胞的直接作用导致细胞膜离子交换改变被认为是RCM诱导血管扩张的一个重要因素。内源性血管活性介质腺苷和内皮素的释放也可能在RCM的血流动力学效应中起关键作用，尤其是在肾脏。此外，RCM对血液流变学的影响可导致微循环血流减少。本综述的目的是讨论RCM血流动力学效应的病理生理学，并深入了解内皮细胞和血管平滑肌细胞的生物学特性以及重要血管活性介质内皮素和腺苷的药理学。
