Lewis J, Sweeney J, Baldini L, Friedland G H, Salzman E W
J Biomed Mater Res. 1985 Feb;19(2):99-113. doi: 10.1002/jbm.820190202.
Assessment of potentially thromboresistant polymers and other materials has been impeded by the lack of a simple and safe test procedure in man. This report describes the use of a portable gamma radiation detector to assess accumulation of 125I-fibrinogen in thrombi related to intravenous cannulae. The method was first employed in 19 dogs and one sheep with FEP-Teflon forelimb intravenous cannulae which were scanned for up to 6 h after insertion. Results were compared with findings at post mortem examination. Eleven thrombi developed, nine of which emitted more than 3500 counts per minute; eight of these (89%) were detected by external scanning. The smallest thrombus detected weighed 0.7 mg. The method did not distinguish between thrombus and hematoma. Fifty FEP-Teflon cannulae were then studied in 39 patients after injection of 100 microCi 125I-fibrinogen. Cannulae and control sites were scanned twice daily and an independent blind clinical appraisal was performed by an experienced nurse. A rise in percentage uptake (count at a limb site/heart count X 100) of 20 or a difference of 40 between adjacent sites was regarded as a positive test. Scans became positive up to 30 h before clinical evidence of phlebitis was observed. The interval between insertion and thrombosis of both large and small cannulae detected by scanning was significantly shorter than that determined by clinical assessment (p less than 0.001). Physical signs of phlebitis were noted with 58% of large cannulae (16 or 18 gauge)and 33% of small cannulae (22 gauge) at the time of removal. Positive 125I-fibrinogen tests were obtained with 70% of large cannulae and 75% of small cannulae. 125I-fibrinogen scanning is a safe simple sensitive technique to detect thrombosis related to intravenous cannulae. The test should enable comparisons of different cannula materials in man.
由于缺乏一种简单且安全的人体测试方法，对潜在抗血栓聚合物和其他材料的评估受到了阻碍。本报告描述了使用便携式γ辐射探测器来评估与静脉插管相关血栓中¹²⁵I-纤维蛋白原的积聚情况。该方法首先应用于19只狗和1只羊，这些动物的前肢插入了FEP-聚四氟乙烯静脉插管，并在插管后长达6小时进行扫描。将结果与尸检结果进行比较。形成了11个血栓，其中9个每分钟发射超过3500次计数；其中8个（89%）通过外部扫描检测到。检测到的最小血栓重0.7毫克。该方法无法区分血栓和血肿。然后，在39名患者注射100微居里¹²⁵I-纤维蛋白原后，对50根FEP-聚四氟乙烯插管进行了研究。插管部位和对照部位每天扫描两次，并由一名经验丰富的护士进行独立的盲法临床评估。肢体部位计数/心脏计数×100的摄取百分比上升20或相邻部位相差40被视为阳性测试。在观察到静脉炎临床证据之前长达30小时，扫描结果变为阳性。通过扫描检测到的大插管和小插管插入与血栓形成之间的间隔明显短于临床评估确定的间隔（p<0.001）。在拔除时，58%的大插管（16或18号）和33%的小插管（22号）出现了静脉炎的体征。70%的大插管和75%的小插管获得了¹²⁵I-纤维蛋白原阳性测试结果。¹²⁵I-纤维蛋白原扫描是一种安全、简单、灵敏的技术，可用于检测与静脉插管相关的血栓形成。该测试应能使人对不同插管材料进行比较。
