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通过即时检验仪器评估醋酸去氨加压素给药对患有1型血管性血友病的杜宾犬原发性止血的影响。

Effect of desmopressin acetate administration on primary hemostasis in Doberman Pinschers with type-1 von Willebrand disease as assessed by a point-of-care instrument.

作者信息

Callan Mary Beth, Giger Urs

机构信息

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

Am J Vet Res. 2002 Dec;63(12):1700-6. doi: 10.2460/ajvr.2002.63.1700.

DOI:10.2460/ajvr.2002.63.1700
PMID:12492285
Abstract

OBJECTIVE

To evaluate primary hemostasis following administration of desmopressin acetate (DDAVP) to Doberman Pinschers with type-1 von Willebrand disease (vWD).

ANIMALS

16 nonanemic Doberman Pinschers with type-1 vWD.

PROCEDURE

Closure time (CT), defined as time required for occlusion of an aperture by a platelet plug assessed within the point-of-care instrument, plasma von Willebrand factor (vWF) concentration, and buccal mucosal bleeding time (BMBT) were determined before and 1 hour after administration of DDAVP (1 microg/kg, SC).

RESULTS

Baseline closure times measured with adenosine diphosphate ([ADP-CT], 108 to > 300 seconds; reference range, 52 to 86 seconds) and epinephrine ([EPI-CT], 285 to > 300 seconds; 97 to 225 seconds) as platelet agonists were prolonged in all dogs. Following DDAVP administration, ADP-CT (59 to 186 seconds) was significantly shortened from baseline, but there was no decrease in EPI-CT. Although mean plasma vWF concentration increased significantly after DDAVP administration, only 1 dog had an increase of > 35 U/dL. There was no correlation between increase in plasma vWF concentration and shortening of the ADP-CT. Baseline BMBT was prolonged in 12 of 14 dogs, with significant shortening of BMBT after DDAVP administration in 6 of 7 dogs. In vitro replacement of vWF-deficient plasma with plasma from an unaffected dog shortened the ADP-CT whereas in vitro addition of DDAVP had no effect.

CONCLUSIONS AND CLINICAL RELEVANCE

Administration of DDAVP to Doberman Pinschers with type-1 vWD resulted in improved hemostatic function, as assessed by the point-of-care instrument and shortening of BMBT, despite minimal increase in plasma vWF concentration.

摘要

目的

评估醋酸去氨加压素(DDAVP)对患有1型血管性血友病(vWD)的杜宾犬的初级止血作用。

动物

16只患有1型vWD的非贫血杜宾犬。

步骤

封闭时间(CT)定义为在即时检测仪器内通过血小板凝块阻塞孔径所需的时间,在给予DDAVP(1微克/千克,皮下注射)之前和之后1小时测定血浆血管性血友病因子(vWF)浓度和口腔黏膜出血时间(BMBT)。

结果

以二磷酸腺苷([ADP-CT],108至>300秒;参考范围,52至86秒)和肾上腺素([EPI-CT],285至>300秒;97至225秒)作为血小板激动剂测得的基线封闭时间在所有犬中均延长。给予DDAVP后,ADP-CT(59至186秒)较基线显著缩短,但EPI-CT无下降。尽管给予DDAVP后血浆vWF平均浓度显著升高,但只有1只犬升高>35 U/dL。血浆vWF浓度升高与ADP-CT缩短之间无相关性。14只犬中有12只基线BMBT延长,7只犬中有6只在给予DDAVP后BMBT显著缩短。用未受影响犬的血浆体外替代vWF缺乏的血浆可缩短ADP-CT,而体外添加DDAVP则无作用。

结论及临床意义

对患有1型vWD的杜宾犬给予DDAVP后,即时检测仪器评估显示止血功能改善,BMBT缩短,尽管血浆vWF浓度仅有轻微升高。

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