Majdalani G, Chomant J, Kachko A, Yanai M, Man N K
General Hospital, Evreux, France.
Kidney Int Suppl. 1993 Jun;41:S131-4.
Technetium-labeled heparin kinetics studies were undertaken in 12 hemodialyzed patients, where heparin was used over a long term (1 to 10 years) for anticoagulation of the extracorporeal circuit. The 99mTc-heparin (99mTc VECTOSCINT, Solabco Nuclear, Coutras, France) used has a 10 mCi activity and a labeling efficiency of more than 95%. Two healthy subjects served as control. After an i.v. bolus of 2 ml 99mTc-heparin, corresponding to 170 +/- 10 IU, radioactivity of kidney, liver, knee and shoulder was recorded with a gamma camera at t1-h, t3-h and t6-h during 120, 152 and 215 s, respectively. Radioactivity recorded was computerized, giving quantitative data for comparison. In hemodialyzed patients, accumulation of radioactivity (mean +/- SEM 10(6) x activity count) was significantly higher at the knee (11.3 +/- 1.1 vs. 4.9 +/- 0.4; p < 0.05; 13.4 +/- 1.1 vs. 5.7 +/- 0.7; < 0.02; and 14.7 +/- 0.8 vs. 5.3 +/- 0.6; < 0.001), and on the shoulder (17.3 +/- 1.1 vs. 10.7 +/- 1.4; p < 0.05; 19.9 +/- 1.0 vs. 10.9 +/- 1.7; < 0.01; 20.8 +/- 1.1 vs. 10.1 +/- 0.9; < 0.01) at t1-h, t3-h and t6-h, respectively, than in control subjects at the same areas. Although direct evidence is not in hand, accumulation of heparin in bone tissue due to renal excretion failure could play a role in mineral metabolism resulting in osteopenia in hemodialyzed patients.
对12名长期（1至10年）使用肝素进行体外循环抗凝的血液透析患者进行了锝标记肝素动力学研究。所使用的99mTc - 肝素（99mTc VECTOSCINT，法国库特拉索拉布科核公司）活性为10毫居里，标记效率超过95%。两名健康受试者作为对照。静脉推注2毫升99mTc - 肝素（相当于170±10国际单位）后，分别在120秒、152秒和215秒时，于t1 - h、t3 - h和t6 - h用伽马相机记录肾脏、肝脏、膝盖和肩部的放射性。记录的放射性数据进行计算机处理，给出定量数据以供比较。在血液透析患者中，在t1 - h、t3 - h和t6 - h时，膝盖处（分别为11.3±1.1对4.9±0.4；p < 0.05；13.4±1.1对5.7±0.7；< 0.02；14.7±0.8对5.3±0.6；< 0.001）和肩部（分别为17.3±1.1对10.7±1.4；p < 0.05；19.9±1.0对10.9±1.7；< 0.01；20.8±1.1对10.1±0.9；< 0.01）的放射性积累显著高于相同部位的对照受试者。尽管尚无直接证据，但由于肾脏排泄功能衰竭导致肝素在骨组织中积累可能在矿物质代谢中起作用，从而导致血液透析患者出现骨质减少。
