Intravenous contrast medium accentuates the severity of acute necrotizing pancreatitis in the rat.
Intravenous contrast medium accentuates the severity of acute necrotizing pancreatitis in the rat.
复制标题
静脉注射造影剂加重了大鼠急性坏死性胰腺炎的严重程度。
DOI：
10.1016/s0016-5085(94)95457-7
复制
发表时间：
1994
期刊：
影响因子：
29.4
通讯作者：
A. Warshaw
中科院分区：
文献类型：
--
作者：
Thomas Foitzik;D. Bassi;J. Schmidt;K. Lewandrowski;C. F. Fernandez;D. Rattner;A. Warshaw
背景/目的对比增强计算机断层扫描（CECT）用于显示严重急性胰腺炎（AP）患者胰腺灌注减少的区域。为了评估造影剂（CM）可能对AP病程产生的不良影响，我们研究了静脉注射造影剂（CM）对严重程度分级的大鼠AP的影响。方法采用静脉注射超刺激蓝蛋白加定时、压控输注生理盐水或糖脱氧胆酸的方法，诱导Sprague-Dawley大鼠三种严重程度的丙型肝炎。7小时时，对照组和胰腺炎动物静脉注射离子CM、非离子CM或生理盐水。主要结局指标为24小时生存率、腹水胰蛋白酶原激活肽（TAP）和组织学腺泡坏死评分。结果CM对对照动物及轻、中度AP动物的指标特征无明显影响。在重度AP动物中，CM导致死亡率、腹水TAP和坏死评分显著升高。结论在严重实验性AP早期给予静脉CM可增加胰腺损伤。由于CM可将交界性缺血转化为不可逆坏死，因此在胰腺炎早期进行CECT以显示灌注不良并预测坏死区域可能是一种自我实现的预言。早期的CECT应该重新考虑，也许应该避免。
Background/AimsContrast-enhanced computed tomography (CECT) is used to show areas of decreased pancreatic perfusion in severe acute pancreatitis (AP). To evaluate possible adverse effects of the contrast medium (CM) on the course of AP, the impact of intravenous CM in AP of graded severity in the rat was studied.MethodsPancreatitis of three levels of severity was induced in Sprague-Dawley rats with intravenous cerulein hyperstimulation plus time- and pressure-controlled intraductal infusion of saline or glycodeoxycholic acid. At 7 hours, control and pancreatitis animals received intravenous ionic CM, nonionic CM, or saline. The principal outcome measures were 24-hour survival, trypsinogen activation peptides (TAP) in ascites, and histological acinar necrosis score.ResultsThere was no measurable effect of CM on the index features in control animals or animals with mild or moderate AP. In severe AP, CM caused a significant increase in mortality, ascites TAP, and necrosis score.ConclusionsIntravenous CM increases pancreatic injury when administered early in the course of severe experimental AP. Because CM may convert borderline ischemia to irreversible necrosis, CECT performed early in pancreatitis to show poor perfusion and predict areas of necrosis may depict a self-fulfilling prophecy. Early CECT should be reconsidered and perhaps avoided.
影响因子：
1.9
作者：
MOBLEY, HLT;HU, LT;FOXALL, PA
通讯作者：
FOXALL, PA