Novitzky D, Cooper D K, Boniaszczuk J
Department of Cardiothoracic Surgery, Groote Schuur Hospital, Cape Town, South Africa.
J Heart Transplant. 1988 Nov-Dec;7(6):453-5.
Sixteen patients underwent heart transplantation (11 orthotopic, five heterotopic). Monitoring for acute rejection was by both endomyocardial biopsy (EMB) and multigated equilibrium blood pool scanning with technetium 99m-labelled red blood cells. From the scans information was obtained on left ventricular volumes (stroke, end-diastolic, and end-systolic), ejection fraction, and heart rate. Studies (208) were made in the 16 patients. There was a highly significant correlation between the reduction in stroke volume and end-diastolic volume (and a less significant correlation in end-systolic volume) and increasing acute rejection seen on EMB. Heart rate and ejection fraction did not correlate with the development of acute rejection. Correlation of a combination of changes in stroke volume and end-diastolic volume with EMB showed a sensitivity of 85% and a specificity of 96%. Radionuclide scanning is therefore a useful noninvasive tool for monitoring acute rejection.
16例患者接受了心脏移植（11例为原位心脏移植，5例为异位心脏移植）。通过心内膜心肌活检（EMB）以及用锝99m标记红细胞的多门控平衡血池扫描来监测急性排斥反应。从扫描中获取左心室容积（每搏量、舒张末期容积和收缩末期容积）、射血分数和心率等信息。对这16例患者进行了208次研究。每搏量和舒张末期容积的减少（收缩末期容积的相关性较弱）与EMB显示的急性排斥反应增加之间存在高度显著的相关性。心率和射血分数与急性排斥反应的发生无关。每搏量和舒张末期容积变化的组合与EMB的相关性显示敏感性为85%，特异性为96%。因此，放射性核素扫描是监测急性排斥反应的一种有用的非侵入性工具。
