Karanikas Georgios, Zedwitz-Liebenstein Konstantin, Eidherr Harald, Schuetz Matthias, Sauerman Robert, Dudczak Robert, Winkler Stefan, Pabinger Ingrid, Kletter Kurt
Department of Nuclear Medicine, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Thromb Haemost. 2004 Mar;91(3):553-7. doi: 10.1160/TH03-07-0489.
Thrombocytopenia is a common occurrence in acute malaria. It is attributed, among other factors, to excessive splenic platelet pooling and a shortened platelet lifespan. The aim of our study was to evaluate the platelet kinetics and sequestration site by isotopic studies in uncomplicated malaria-induced thrombocytopenia. Seven thrombocytopenic malaria patients (74,000+/-36,000 platelets/ micro l) were included in the study. Autologous (111)In-labeled platelet scintigraphy was performed up to 96 hours (h) post injection (p.i.) to evaluate the platelet sequestration site. Late sequestration for the spleen (S) and the liver (L) was analyzed according to the following activity ratios: S (spleen count on the last day of the platelet lifespan / spleen count at 30 min) and L (liver count on the last day of the platelet lifespan / liver count at 30 min). Additionally, platelet survival studies were performed. A normal late sequestration (S: 0.95+/-0.06 and L: 1.04+/-0.08; normal values, S and L: 1+/-0.2.) was observed in all of our patients. The platelet lifespan was reduced (1 to 4 days; normal range, 7-9 days), recovery was normal (mean, 63+/-6%; normal range, 55-75%), and the turnover rate was enhanced (mean, 95,000+/-80,000/ micro l/day; normal value, 35,000+/-4,500/ micro l/ day). According to the results of scintigraphy, the sequestration site by uncomplicated malaria-induced thrombocytopenia appears to be non-splenic and/or hepatic, yet diffuse.
血小板减少症在急性疟疾中很常见。除其他因素外，它归因于脾脏血小板过度蓄积和血小板寿命缩短。我们研究的目的是通过同位素研究评估单纯性疟疾所致血小板减少症患者的血小板动力学和滞留部位。7名血小板减少的疟疾患者（血小板计数为74,000±36,000/微升）被纳入研究。在注射后长达96小时进行自体（111）铟标记血小板闪烁扫描，以评估血小板滞留部位。根据以下活性比分析脾脏（S）和肝脏（L）的晚期滞留情况：S（血小板寿命最后一天的脾脏计数/30分钟时的脾脏计数）和L（血小板寿命最后一天的肝脏计数/30分钟时的肝脏计数）。此外，还进行了血小板存活研究。我们所有患者均观察到正常的晚期滞留情况（S：0.95±0.06，L：1.04±0.08；正常值，S和L：1±0.2）。血小板寿命缩短（1至4天；正常范围为7 - 9天），恢复正常（平均值为63±6%；正常范围为55 - 75%），周转率增加（平均值为95,000±80,000/微升/天；正常值为35,000±4,500/微升/天）。根据闪烁扫描结果，单纯性疟疾所致血小板减少症的滞留部位似乎并非脾脏和/或肝脏，而是弥散性的。
