Najean Y, Dufour V, Rain J D, Toubert M E
Department of Nuclear Medicine, Hôpital Saint-Louis, Paris, France.
Br J Haematol. 1991 Oct;79(2):271-6. doi: 10.1111/j.1365-2141.1991.tb04532.x.
The significance of the site of platelet sequestration in determining the indication for splenectomy in idiopathic thrombocytopenic purpura (ITP) is a controversial subject. However, most of the negative conclusions are based on 51chromium labelling of homologous platelets. We report here the results of an analysis of 222 cases in which the kinetic study of 111indium-oxinate-labelled autologous platelets was performed under homogeneous technical conditions. 103 of these patients subsequently underwent splenectomy. This study demonstrates that the site of platelet sequestration in active ITP constitutes a variable independent of the patient's age, history of the disease and its severity (platelet count, lifespan). The sequestration site is a good predictive element of the short-term efficacy of splenectomy (71/76 cases with splenic sequestration obtained a platelet count exceeding 100 x 10(9)/l versus 7/13 cases with mixed sequestration and 1/14 cases with hepatic sequestration), and the long-term results (6 months to 5 years after splenectomy) do confirm the clinical value of this study.
血小板滞留部位在确定特发性血小板减少性紫癜（ITP）脾切除术指征中的意义是一个有争议的话题。然而，大多数否定性结论是基于对同种血小板进行的51铬标记得出的。我们在此报告对222例患者的分析结果，这些患者在相同技术条件下对111铟-氧肟酸盐标记的自体血小板进行了动力学研究。其中103例患者随后接受了脾切除术。本研究表明，活动性ITP中血小板滞留部位是一个变量，与患者年龄、疾病史及其严重程度（血小板计数、生存期）无关。滞留部位是脾切除术短期疗效的良好预测因素（76例脾滞留患者中有71例血小板计数超过100×10⁹/L，而混合性滞留的13例患者中有7例，肝滞留的14例患者中有1例），并且长期结果（脾切除术后6个月至5年）确实证实了本研究的临床价值。
