- 期刊
Effect of Ionic and Nonionic Contrast Media on Fibrinolysis in Patients Undergoing Angiocardiography
離子性與非離子性顯影劑對接受心血管攝影的病人纖維蛋白溶解之影響
摘要
顯影劑對纖維蛋白溶解的影響之相關研究，仍相當少。以前研究的結果互相矛盾且未確定。本研究之目的，即在評估離子性及非離子性顯影劑對接受心血管攝影的病人纖維蛋白溶解之影響。總共62位病人，隨機分為兩組。其中一組（31人）接受離子性顯影劑（Hypaque-76）；另外一組（31人）接受非離子性顯影劑（Ultravist-370）。在心血管攝影之前及20分鐘之後，抽血測血漿的組織漿胞素原活化劑（t-PA），漿胞素原活化劑之抑制劑（PAI-1），纖維蛋白原（fibrinogen）及D雙體（D-dimer）。Ultravist組在心血管攝影後，漿胞素原活化劑之抑制劑明顯升高；然而Hypaque組則無明顯改變。組織漿胞素原活化劑及纖維蛋白原在兩組皆維持不變。於Hypaque組，D雙體明顯升高；但Ultravist組則無明顯改變。本研究的結果也許可部份解釋為何在心導管過程中，使用離子性顯影劑比非離子性顯影劑較少發生血栓栓塞之併發症。
關鍵字
無資料並列摘要
Very few investigators have studied the effect of contrast media on fibrinolysis. The results of those previous studies are contradictory and inconclusive. The purpose of this study was to evaluate the effect of ionic and nonionic contrast media on fibrinolysis in patients undergoing angiocardiography. Sixty-two patients randomly received either ionic contrast medium Hypaque-76 (n=31) or nonionic contrast medium Ultravist-370 (n=31). Plasma tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), fibrinogen, and D-dimer were measured before and 20 minutes after the procedures. A significant increase of PAI-1 levels was seen in the Ultravist group but not in the Hypaque group. The t-PA and fibrinogen levels remained virtually unchanged in both groups. A significant increase of D-dimer concentrations was observed in the Hypaque group but not in the Ultravist group. The results of this study may in part explain the reason that the ionic contrast media produce fewer thromboem-bolic complications than the nonionic contrast media during the cardiac catheterization.