Addonizio L J
Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY 10023.
Prog Cardiovasc Dis. 1990 Sep-Oct;33(2):73-83. doi: 10.1016/s0033-0620(05)80030-1.
The results of the investigations in the search for a radionuclide technique to detect rejection have, thus far, not found any method that can be applied clinically. Functional studies are not sensitive enough, unless further work on the quantitative volume changes shows consistent correlation. "Routine" myocardial imaging agents such as 67Ga, 99TcPP, or the perfusion agent, 201Tl are clearly not specific enough to detect rejection until the grafts are nearly lost. Radiolabeled lymphocyte studies show promise, in that lymphocytes are intimately involved in the rejection process. However, there needs to be further research to determine if the specificity of the technique can isolate those patients who require treatment. The data involving labeled antimyosin antibody fragments indicate that they can specifically detect myocyte necrosis that occurs on the microscopic level. However, it may also be too sensitive a technique for transplanted hearts, which are so immunologically active at baseline to determine when treatment is necessary.
迄今为止，在寻找用于检测排斥反应的放射性核素技术的研究中，尚未发现任何可应用于临床的方法。功能研究不够敏感，除非对定量体积变化的进一步研究显示出一致的相关性。诸如67Ga、99TcPP或灌注剂201Tl等“常规”心肌显像剂显然特异性不足，无法在移植心脏几乎失功之前检测到排斥反应。放射性标记淋巴细胞研究显示出前景，因为淋巴细胞密切参与排斥反应过程。然而，需要进一步研究以确定该技术的特异性是否能够识别出需要治疗的患者。涉及标记抗肌球蛋白抗体片段的数据表明，它们能够特异性检测微观层面上发生的心肌细胞坏死。然而，对于移植心脏来说，这一技术可能过于敏感，因为移植心脏在基线时免疫活性就很高，难以确定何时需要治疗。
