Leithner C, Sinzinger H, Schwarz M, Ulrich W
Br J Radiol. 1985 Nov;58(695):1057-63. doi: 10.1259/0007-1285-58-695-1057.
During the last four years, we have performed two studies on the clinical application of 111In-platelet scintigraphy after renal transplantation. In the first study, we collected 75 patients who were treated with prednisolone and azathioprine. The platelet deposition in the graft was expressed as a platelet-uptake index (PUI). The results suggested that the platelet scan was a valuable tool for early detection of acute graft rejection, which was indicated by an increase in PUI. Quite different results were obtained in 50 patients immunosuppressed with cyclosporin A (CSA) and prednisolone. Acute interstitial rejection escaped detection by this diagnostic procedure. Significant elevations of PUI were observed in acute vascular rejection and microvascular CSA nephrotoxicity, resembling the haemolytic uraemic syndrome (HUS) only. Therefore, platelet deposition in the graft can be regarded as a non-specific phenomenon, occurring in two entities which require completely different therapeutic approaches. In spite of the monitoring by means of the platelet scan, percutaneous biopsy is still necessary for differential diagnosis of graft dysfunction.
在过去四年中，我们进行了两项关于肾移植后¹¹¹铟标记血小板闪烁扫描术临床应用的研究。在第一项研究中，我们收集了75例接受泼尼松龙和硫唑嘌呤治疗的患者。移植物中的血小板沉积用血小板摄取指数（PUI）表示。结果表明，血小板扫描是早期检测急性移植物排斥反应的一种有价值的工具，急性移植物排斥反应表现为PUI升高。在用环孢素A（CSA）和泼尼松龙进行免疫抑制的50例患者中得到了截然不同的结果。急性间质性排斥反应通过这种诊断方法未被检测到。在急性血管排斥反应和微血管CSA肾毒性中观察到PUI显著升高，仅类似于溶血尿毒综合征（HUS）。因此，移植物中的血小板沉积可被视为一种非特异性现象，发生在两个需要完全不同治疗方法的实体中。尽管通过血小板扫描进行监测，但经皮活检对于移植物功能障碍的鉴别诊断仍然是必要的。
