非离子型造影剂对CT受检者血液流变学指标的影响

The Effect of Nonionic Contrast Medium on Hemorheology Indexes in CT Scanned Patients

目的:观察CT增强注射非离子型造影剂碘海醇(欧乃派克)后受检者全血表观粘度等血液流变学指标的变化情况。方法:57例行CT增强扫描者,于注射碘海醇造影前、造影后0.5h及和24h采集静脉血,检测其全血表观粘度、血浆粘度、红细胞压积、红细胞变形指数和红细胞聚集指数,并对结果进行统计学分析。结果:注射造影剂0.5h后,无论切变率高低,全血表观粘度均较注射前下降,尤以低切变率表观粘度下降明显(P<0.05);注射后24h,高、中、低切变率表观粘度均较注射后0.5h明显升高(P<0.05)。红细胞变形指数和红细胞聚集指数在注射后0.5h和24h均较注射前明显升高(P<0.05)。结论:非离子型造影剂碘海醇通过对红细胞变形性和聚集性的影响而增加血液粘滞性,可能是其引起肾衰竭等副反应的重要原因之一。

Objective:To observe the whole blood apparent viscosity,erythrocyte deformability,and erythrocyte aggregation in patients after injecting Iohexol/Omnipaque. Method:We collected 57 patients who performed contrast enhanced CT-scanning,compared and analysed the whole blood apparent viscosity,erythrocyte deformability index (EDI) and erythrocyte aggregation index (EAI) before,0.5h and 24h after injecting Iohexol. Results:Whether high or low shear rates,the whole blood viscosity decreased 0.5h after the injection of contrast medium. The whole blood viscosity in low shear rates did vary significantly; The whole blood viscosity in high shear rates and low shear rates increased significantly 24h after the injection of contrast medium (P<0.05),while the whole blood viscosity in middle did not vary significantly. The EDI and EAI increased significantly 0.5h and 24h after the injection of contrast medium (P<0.05).Conclusion:Because of the hypertonicity of contrast medium,The nonionic iodinated contrast medium (Iohexol) can increase the blood viscosity in high and low shear rates through damage the deformability and aggregation of the red blood cell. And this may one of the reasons lead to acute renal failure (ARF).