Yamada M, Onishi K, Fukunami M, Hiranaka T, Ohmori M, Sakaki S, Nishimura M, Sakamoto T, Hashimura K, Ikeda T
Heart Center, Osaka Prefectural Hospital, Japan.
Jpn Circ J. 1988 Dec;52(12):1357-64. doi: 10.1253/jcj.52.1357.
Twenty patients in whom intracardiac thrombi were detected by indium-111 platelet scintigraphy (the first platelet scintigraphy) were prospectively studied to examine the effect of warfarin therapy under full dose on the intracardiac thrombogenicity. Eleven patients (group I) who received 2-6 mg/day of warfarin and 9 patients (group II) who did not receive warfarin had the second platelet scintigraphies 14-71 days after the first platelet scintigraphies. In group I, 10 platelet scintigraphies became negative and one remained positive for intracardiac thrombi after administration of warfarin, while in group II 8 platelet scintigraphies remained positive and only one changed to negative. The incidence of negative image at the second platelet scintigraphy was significantly lower in group II than that in group I. In group I, the degree of accumulation of platelets onto the surface of the thrombus (%IE), showed significant reduction (0.69 +/- 0.48 to 0.11 +/- 0.21) after warfarin therapy, while in group II %IE at the second scintigraphy (1.07 +/- 1.03) were not significantly different from those at the first scintigraphy (1.13 +/- 0.79). These results indicated that warfarin therapy under full dose inhibited the deposition of platelets on the intracardiac thrombi and thrombogenicity in the patients with intracardiac thrombi which were detected by indium-111 platelet scintigraphy.
对20例通过铟111血小板闪烁显像（首次血小板闪烁显像）检测出心内血栓的患者进行前瞻性研究，以检查全剂量华法林治疗对心内血栓形成倾向的影响。11例接受2 - 6毫克/天华法林治疗的患者（第一组）和9例未接受华法林治疗的患者（第二组）在首次血小板闪烁显像后14 - 71天进行了第二次血小板闪烁显像。在第一组中，服用华法林后10次血小板闪烁显像变为阴性，1次心内血栓仍为阳性，而在第二组中，8次血小板闪烁显像仍为阳性，只有1次变为阴性。第二组第二次血小板闪烁显像时阴性图像的发生率显著低于第一组。在第一组中，华法林治疗后血栓表面血小板聚集程度（%IE）显著降低（从0.69±0.48降至0.11±0.21），而在第二组中，第二次闪烁显像时的%IE（1.07±1.03）与第一次闪烁显像时（1.13±0.79）无显著差异。这些结果表明，全剂量华法林治疗可抑制通过铟111血小板闪烁显像检测出的心内血栓患者血小板在心脏血栓上的沉积及血栓形成倾向。
