McAllister H A
Department of Pathology, St. Luke's Episcopal Hospital and Texas Heart Institute, Houston 77030.
J Heart Transplant. 1990 May-Jun;9(3 Pt 2):277-82.
At the Texas Heart Institute, cardiac allograft rejection is evaluated by a quantitative, or numerical, scale ranging from 0 to 10. This scale provides objectivity as to the degree of cardiac allograft rejection and thus enhances communication between pathologists, surgeons, cardiologists, nurses and patients. The system is simple, reproducible with minimal interobserver variability, and is easily learned. Each time a grade of rejection changes for a patient, alterations are required in the therapeutic approach, especially in the "moderate" range (grades 4-8). By plotting the numerical value and date of a patient's previous endomyocardial biopsies on the 0-10 scale, accurate determinations may be made of (1) the degree of cardiac allograft rejection, (2) the direction of change (resolving or progressing), and (3) the speed of change. All three parameters are important in determining the appropriate immunosuppressive regimen and biopsy interval for each patient.
在德克萨斯心脏研究所，心脏同种异体移植排斥反应通过一个从0到10的定量或数值量表进行评估。该量表为心脏同种异体移植排斥反应的程度提供了客观性，从而加强了病理学家、外科医生、心脏病专家、护士和患者之间的沟通。该系统简单，观察者间变异性最小，易于重复且容易掌握。每当患者的排斥反应等级发生变化时，治疗方法都需要改变，尤其是在“中度”范围内（4 - 8级）。通过在0 - 10量表上绘制患者先前心内膜活检的数值和日期，可以准确确定：（1）心脏同种异体移植排斥反应的程度；（2）变化方向（缓解或进展）；（3）变化速度。这三个参数对于确定每位患者合适的免疫抑制方案和活检间隔都很重要。
