Martin-Comin J
Int J Rad Appl Instrum B. 1986;13(2):173-81. doi: 10.1016/0883-2897(86)90233-3.
The usefulness of In-111-labelled platelets and lymphocyte scintigraphy in acute kidney graft rejection is evaluated. One hundred fifty-five patients (36 treated with cyclosporine A) were studied with labelled platelets and 27 with labelled lymphocytes. Blood cels were labelled with 100-150 microCi of In-111-oxine and reinjected. Subsequently patients were scanned once daily from 2 hours post-reinjection up to a week. The graft/contralateral area activity ratio was calculated in all scans (index I). Four groups of patients were established: Functioning grafts (FG); post-operative acute renal failure (p-ARF); acute rejection (AR) and nephrotoxicity (NTX), the last one only in patients under cyclosporine therapy. Results with labelled platelets showed similar index I mean values in FG, p-ARF and NTX patients I = 1.1 +/- 0.1 and a significant increase (p less than 0.001), in acutely rejecting grafts I = 1.9 +/- 0.4. Evolving controls showed a decrease a decrease of graft activity parallel to rejection resolution while the activity maintains or increases in patients with less or no response to treatment. Overall sensitivity was 97.2%, specificity 90.2% and accuracy 92.8%. Results with labelled lymphocytes were similar to those with platelets. They showed a significant (p 0.001) difference of activity index between rejecting (I = 1.86 +/- 0.3) and non rejecting grafts (I = 1.05 +/- 0.1). Decrease of graft activity was only seen in patients with good response to treatment. It is concluded that In-111-labelled platelets scintigraphy is nowadays the method of choice for acute kidney graft rejection diagnosis, especially in patients under cyclosporine immunosuppression.
评估了铟 - 111标记的血小板和淋巴细胞闪烁显像在急性肾移植排斥反应中的作用。对155例患者（36例接受环孢素A治疗）进行了标记血小板研究，对27例患者进行了标记淋巴细胞研究。血细胞用100 - 150微居里的铟 - 111 - 氧嗪标记后重新注入。随后，患者从重新注入后2小时起每天扫描一次，持续一周。在所有扫描中计算移植肾/对侧区域活性比（指数I）。将患者分为四组：功能正常的移植肾（FG）；术后急性肾衰竭（p - ARF）；急性排斥反应（AR）和肾毒性（NTX），最后一组仅包括接受环孢素治疗的患者。标记血小板的结果显示，FG、p - ARF和NTX患者的指数I平均值相似（I = 1.1±0.1），而急性排斥反应的移植肾中指数I显著升高（p＜0.001，I = 1.9±0.4）。动态对照显示，随着排斥反应的缓解，移植肾活性降低，而对治疗反应较小或无反应的患者，其活性保持或升高。总体敏感性为97.2%，特异性为90.2%，准确性为92.8%。标记淋巴细胞的结果与标记血小板的结果相似。它们显示，排斥反应的移植肾（I = 1.86±0.3）和非排斥反应的移植肾（I = 1.05±0.1）之间的活性指数存在显著差异（p＜0.001）。仅在对治疗反应良好的患者中观察到移植肾活性降低。结论是，如今铟 - 111标记的血小板闪烁显像术是诊断急性肾移植排斥反应的首选方法，尤其是在接受环孢素免疫抑制治疗的患者中。
