低渗对比剂碘克酸和等渗对比剂碘克沙醇对血小板和白细胞活化的影响  

Low Osmotic Contrast Medium Ioxaglate and Iso-osmotic Contrast Medium Iodixanol Show Different Influence on Platelet and Leukocyte Activation

作　　者：纪求尚[1] 李奈林 张运[1] 刘淼[1] 

机构地区：[1]教育部和卫生部心血管重构和功能研究重点实验室山东大学齐鲁院心内科,济南250012 [2]卡罗林斯卡大学医院内科临床药理实验室,瑞典斯德哥尔摩se17176

出　　处：《中国动脉硬化杂志》2010年第8期607-610,共4页Chinese Journal of Arteriosclerosis

基　　金：瑞典心-肺基金会;瑞典研究理事会(5930)

摘　　要：目的探讨低渗对比剂碘克酸和等渗对比剂碘克沙醇对血小板和白细胞活化的影响。方法将水蛭素抗凝的全血分别与0%、2%、5%、10%不同浓度的等渗对比剂碘克沙醇和低渗对比剂碘克酸在37℃温度下抚育5 min,用全血流式细胞技术测定血小板活化指标P选择素、白细胞活化指标CD11b,以及血小板-白细胞聚集体。结果 2%、5%、10%3种不同浓度的碘克酸对自发的血小板P选择素的表达没有影响(P=0.237),而碘克沙醇轻度增加其表达(P<0.01);两者均显著降低1μmol/L二磷酸腺苷诱导的P选择素表达(P<0.001),同时也降低二磷酸腺苷刺激的血小板-白细胞聚集(P<0.001),这一作用不受对比剂浓度的影响。无论是自发状态下,还是在0.1μmol/L N-甲酰-甲硫氨酰-亮氨酰-苯丙氨酸刺激下,碘克酸对白细胞活化指标CD11b的表达没有影响,而碘克沙醇在两种状态下均轻度增加CD11b的表达(P<0.05)。碘克酸对胶原刺激血小板后诱导的CD11b的表达有抑制作用(P<0.05),而碘克沙醇对此无影响;但两者对胶原刺激的血小板-白细胞聚集体形成均有明显抑制作用(P<0.05)。结论对比剂碘克沙醇和碘克酸均能降低二磷酸腺苷刺激的血小板活化和血小板-白细胞聚集。碘克酸不影响自发的P选择素表达和白细胞活化,而碘克沙醇轻度增加自发的血小板和白细胞活化。就对血小板和白细胞影响方面而言,低渗对比剂碘克酸比等渗对比剂碘克沙醇应用更为安全。Aim To elucidate the effect of low osmotic contrast medium ioxaglate and iso-osmotic contrast medium iodixanol on platelet and leukocyte activation. Methods Hirudinized whole blood was incubated with 0%,2%,5% and 10% concentrations of ioxaglate or iodixanol at 37℃ for 5 min.Whole blood flow cytometric method was used to measure P-selectin,marker of platelet activation,CD11b,marker of leukocyte activation,and platelet-leukocyte aggregates.Blood samples were also incubated with collagen with stirring to investigate the impact of contrast medium（5% of ioxaglate or iodixanol） on platelet-leukocyte cross-talk. Results Ioxaglate had no effect on P-selectin expression of un-stimulated samples（P=0.237）,whilst iodixanol mildly increased P-selectin expression（P〈0.01）;However,both contrast media remarkably decreased 1 μmol/L adenosine diphosphate（ADP）-induced P-selectin expression（P〈0.001）,and ADP-stimulated platelet-leukocyte aggregates（P〈0.001）.Ioxaglate had effect on neither resting nor 0.1 μmol/L N-formyl-methionyl-leucyl phenylalanine（fMLP）-stimulated CD11b expression,whilst iodixanol mildly increased both resting and 0.1 μmol/L fMLP-stimulated CD11b expression（P〈0.05）.Ioxaglate inhibited collagen-stimulated platelet-induced CD11b expression（P〈0.05）,whilst iodixanol had no impact on platelet-leukocyte cross-talk.Both ioxaglate and iodixanol markedly reduced collagen-stimulated platelet-leukocyte aggregates（P〈0.01）. Conclusion Both ioxaglate and iodixanol can reduce ADP-stimulated P-selectin expression and platelet-leukocyte aggregates.Yet,iodixanol slightly increases resting P-selectin expression,and both resting and fMLP-stimulated CD11b expression.As far as the influence on platelet and leukocyte activation is concerned,ioxaglate is safer than iodixanol when used clinically.

关 键 词：全血流式细胞技术 血小板激活 白细胞激活 血小板-白细胞聚集 碘对比剂 碘克酸 碘克沙醇 

分 类 号：R5[医药卫生—内科学]