Minar E, Ehringer H, Ahmadi R, Dudczak R, Porenta G
Department of Angiology, I. Medical University Clinic, Vienna, Austria.
Thromb Haemost. 1987 Aug 4;58(2):718-23.
In this study we have assessed the deposition of 111-In-oxine-labelled platelets--using a dual radiotracer method--at angioplasty sites of the lower extremities in 20 patients (14 male, 6 female; median age: 60 years) with ASA (1.0 g/day)-therapy. The platelet survival time (PST)--using the multiple hit model--was evaluated before and after percutaneous transluminal angioplasty, and we also measured the plasma levels of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF 4) before and after PTA. Before PTA, scintigraphy was positive in only one patient, while 24 hours after PTA a positive scintigraphic result was observed in 16/20 patients. The median target/non target-ratio was 1.0 (0.66-1.3) before PTA, and this ratio increased significantly (p less than 0.0005) to 1.53 (1.0-3.3) after PTA. The median PST decreased significantly (185.0 hours before PTA----145.2 hours after PTA; p less than 0.001), while the median platelet turnover increased from 34,000/microliter/day to 47,900/microliter/day (p less than 0.01). The median plasma levels of the platelet specific proteins increased significantly immediately after PTA (p less than 0.001), but one day later they were not significantly different from the pretreatment values. The quantitative methods used in this study seem a valuable tool to evaluate the effects of different therapeutical--especially antiplatelet--interventions after PTA in humans, thus helping to find the best antithrombotic regimen for this widely used therapeutical procedure.
在本研究中,我们采用双放射性示踪剂法评估了20例接受阿司匹林(1.0克/天)治疗的患者(14例男性,6例女性;中位年龄:60岁)下肢血管成形术部位111-铟-奥克辛标记血小板的沉积情况。使用多重打击模型评估经皮腔内血管成形术前后的血小板存活时间(PST),并且我们还测量了经皮腔内血管成形术前后血浆β-血小板球蛋白(β-TG)和血小板因子4(PF 4)的水平。经皮腔内血管成形术之前,闪烁扫描仅在1例患者中呈阳性,而经皮腔内血管成形术后24小时,16/20例患者出现闪烁扫描阳性结果。经皮腔内血管成形术之前,中位靶/非靶比值为1.0(0.66 - 1.3),该比值在经皮腔内血管成形术后显著升高(p < 0.0005)至1.53(1.0 - 3.3)。中位PST显著降低(经皮腔内血管成形术之前为185.0小时 ---- 经皮腔内血管成形术后为145.2小时;p < 0.001),而中位血小板周转率从34,000/微升/天增加至47,900/微升/天(p < 0.01)。血小板特异性蛋白的中位血浆水平在经皮腔内血管成形术后立即显著升高(p < 0.001),但一天后与预处理值无显著差异。本研究中使用的定量方法似乎是评估人类经皮腔内血管成形术后不同治疗干预(尤其是抗血小板干预)效果的有价值工具,从而有助于为这种广泛应用的治疗程序找到最佳抗血栓形成方案。