Splenectomy in idiopathic thrombocytopenic purpura: its correlation with the sequestration of autologous indium-111-labeled platelets.
Splenectomy in idiopathic thrombocytopenic purpura: its correlation with the sequestration of autologous indium-111-labeled platelets.
复制标题
特发性血小板减少性紫癜的脾切除术：其与自体铟 111 标记血小板隔离的相关性。
DOI：
--
复制
发表时间：
1993
影响因子：
9.3
通讯作者：
P. Le Prise
中科院分区：
文献类型：
--
作者：
T. Lamy;A. Moisan;C. Dauriac;C. Ghandour;P. Morice;P. Le Prise
我们回顾性分析了111例临床诊断为特发性血小板减少性紫癜（ITP）患者的111 In-血小板隔离研究。这些患者中有51例接受了脾切除术，独立于111 In-血小板研究的结果，以确定这些同位素结果是否可以准确预测脾切除术的有益反应。1984年1月至1990年6月，111例ITP患者接受了自体111 In标记血小板的研究。血小板隔离部位为脾脏（81%）、混合型（12%）或肝脏（7%）。51例持续性耐药血小板减少症患者接受了脾切除术，无论同位素结果如何：33例患者在诊断后6个月以上，18例患者在此延迟之前具有高出血风险。平均随访时间为2.9年。38例脾隔离症患者中有33例血小板计数正常，而13例混合性或肝隔离症患者中有2例血小板计数正常（p < 0.001）。此外，6名患者的血小板存活时间超过8天，没有明显的隔离部位。用这种技术进行的血小板同位素研究似乎适用于ITP：它指导临床医生决定进行脾切除术，并与某些不适当归类为ITP的血小板减少症的更重要机制有关。
We present a retrospective analysis of 111In-platelet sequestration studies in 111 patients with the clinical diagnosis of idiopathic thrombocytopenic purpura (ITP). Fifty-one of these patients underwent splenectomy, independent of the results of the 111In-platelet studies to determine if these isotopic results could accurately predict a beneficial response to splenectomy. Between January 1984 and June 1990, 111 patients who presented with ITP were subjected to a study of autologous 111In-labeled platelets through autotransfusion. The platelet sequestration site was splenic (81%), mixed (12%), or hepatic (7%). Fifty-one patients with persistent drug-resistant thrombocytopenia underwent splenectomy regardless of the isotopic results: 33 patients beyond 6 mo after diagnosis and 18 with high hemorrhagic risks before this delay. The follow-up median duration was 2.9 yr. Thirty-three of the 38 patients with splenic sequestration showed a normalized platelet count, as opposed to 2 of the 13 with mixed or hepatic sequestration (p < 0.001). In addition, platelet survival extended beyond 8 days in six patients, with no apparent sequestration site. The platelet isotopic study performed with this technique appears to be indicated in ITP: it guides clinicians in their decision to perform splenectomy and relates to a more central mechanism certain thrombocytopenias that are inappropriately categorized as ITP.