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血小板闪烁扫描术在闭塞性动脉硬化症诊断中的应用

Platelet scintigraphy in the diagnosis of arteriosclerosis obliterans.

作者信息

Morimoto Yoshihisa, Sugimoto Takaki, Okada Masayoshi, Okita Yutaka, Mukai Tomoichiro

机构信息

Department of Surgery, Division II, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.

出版信息

Surg Today. 2002;32(10):875-9. doi: 10.1007/s005950200170.

Abstract

PURPOSE

We evaluated the efficacy of platelet scintigraphy using autologous platelets labeled with 111In-oxine, to assess the degree of arteriosclerotic activity in arteriosclerosis obliterans (ASO).

METHODS

Thirty-three patients with clinical signs of ASO, seen between January 1996 and August 1999, were enrolled in this study. Scintigraphic imaging results were compared with the findings of contrast angiography in 26 patients, 17 of whom were taking antiplatelet and/or anticoagulant drugs during the platelet imaging study.

RESULTS

Angiography demonstrated atherosclerotic lesions at 38 sites from the abdominal aorta to the popliteal arteries in 23 patients. There was an accumulation of platelets at 17 of these sites (45%) and at 6 other sites without definite angiographic abnormalities. Lesions that resulted in less than 50% stenosis were detected slightly, but not significantly, less often than lesions with higher degrees of stenosis and occlusion (50% vs 30%, P = 0.73). The frequency of true-positive scintigraphic results was statistically higher in patients not taking antithrombotic agents than in those taking antithrombotic agents (70% vs 32%, P = 0.02).

CONCLUSIONS

Our results suggest that imaging with 111In-oxine-labeled platelets may be useful for evaluating the pathophysiologic characteristics of atherosclerotic lesions in patients with ASO.

摘要

目的

我们评估了使用111铟-奥克辛标记的自体血小板进行血小板闪烁扫描术的疗效,以评估闭塞性动脉硬化症(ASO)中动脉硬化活动的程度。

方法

本研究纳入了1996年1月至1999年8月间出现ASO临床症状的33例患者。将26例患者的闪烁扫描成像结果与血管造影结果进行比较,其中17例患者在血小板成像研究期间正在服用抗血小板和/或抗凝药物。

结果

血管造影显示23例患者从腹主动脉到腘动脉的38个部位存在动脉粥样硬化病变。其中17个部位(45%)有血小板聚集,另外6个部位虽血管造影无明确异常但也有血小板聚集。导致狭窄小于50%的病变被检测到的频率略低于狭窄和闭塞程度更高的病变(50%对30%,P = 0.73),但差异无统计学意义。未服用抗血栓药物的患者闪烁扫描结果真阳性频率在统计学上高于服用抗血栓药物的患者(70%对32%,P = 0.02)。

结论

我们的结果表明,111铟-奥克辛标记血小板成像可能有助于评估ASO患者动脉粥样硬化病变的病理生理特征。

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