Changes in platelet kinetics after a partial splenic arterial embolization in cirrhotic patients with hypersplenism
Changes in platelet kinetics after a partial splenic arterial embolization in cirrhotic patients with hypersplenism
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DOI：
10.1002/hep.1840220611
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发表时间：
1995-12
期刊：
影响因子：
13.5
通讯作者：
H. Noguchi;K. Hirai;Y. Aoki;K. Sakata;K. Tanikawa
中科院分区：
文献类型：
--
作者：
H. Noguchi;K. Hirai;Y. Aoki;K. Sakata;K. Tanikawa
我们对 22 名伴有血小板减少症的肝硬化患者进行了部分脾动脉栓塞，然后使用 111In-tropolone 标记的血小板评估了手术后血小板动力学的变化。对照组由八名慢性肝炎患者组成，他们的血小板计数和脾脏大小均正常。术后平均脾梗死率为54.9%。在手术前和手术后两个月进行血小板动力学研究。术前，与对照组相比，肝硬化患者的脾体积以及脾/肝对 111In 标记血小板的摄取比在第 3 天和第 7 天均有所增加，而血小板回收率则有所下降，这表明脾脏中的血小板池有所增加。此外，肝硬化患者血小板存活时间缩短，而血小板相关免疫球蛋白G（PA-IgG）高于对照组，提示血小板减少涉及免疫机制。随着部分脾动脉栓塞术后血小板计数的增加，111In标记血小板的脾/肝摄取比下降，而血小板回收率增加。此外，血小板存活时间延长，而PA-IgG下降。术前、术后血小板计数与血小板存活时间呈正相关，与PA-IgG呈负相关。这些结果表明，经导管脾动脉栓塞不仅可以减少脾脏中增加的血小板池，还可以改善肝硬化患者由免疫机制引起的血小板减少症。 （肝病学 1995；22：1682-1688）。
We performed a partial splenic arterial embolization in 22 patients with cirrhosis associated with thrombocy‐topenia and then evaluated the changes in platelet kinetics after undergoing the procedure using 111In‐tropolone–labeled platelets. The controls consisted of eight chronic hepatitis patients who showed a normal platelet count and normal spleen size. The mean splenic infarction ratio after the procedure was 54.9%. A platelet kinetics study was performed before and 2 months after the procedure. Before the procedure, the cirrhotic patients showed increases in the splenic volume and the spleen/liver uptake ratio of the 111In‐labeled platelets on both the third and seventh days, and a decrease in the platelet recovery compared with the controls, which suggested an increased platelet pool in the spleen. In addition, the platelet survival time in cirrhotic patients was shortened, whereas the platelet‐associated immuno‐globulin G (PA‐IgG) was higher than that of the controls, which suggested the involvement of immunologic mechanisms in the thrombocytopenia. With an increase of the platelet count after a partial splenic arterial embolization, the spleen/liver uptake ratio of the 111In‐labeled platelets decreased, whereas the platelet recovery increased. Furthermore, the platelet survival time was prolonged, whereas the PA‐IgG decreased. The platelet count showed a positive correlation with the platelet survival time and a negative correlation with PA‐IgG before and after the procedure. These results suggest that a transcatheter splenic arterial embolization not only may reduce the increased platelet pool in the spleen but also may improve the thrombocytopenia induced by immunologic mechanisms in patients with cirrhosis. (Hepatology 1995; 22:1682‐1688).