Yilmaz Zeki, Ilcol Yesim Ozarda, Ulus Ismail Hakki
Department of Internal Medicine, Veterinary Faculty, Uludag University, Bursa, Turkey.
Berl Munch Tierarztl Wochenschr. 2005 Jul-Aug;118(7-8):341-8.
This study was performed to evaluate the diagnostic importance of the platelet closure times measured by the Platelet Function Analyzer (PFA-100) in dogs with endotoxemia. E. coli endotoxin was given intravenously once, at the dose of 0.02 mg/kg or 1 mg/kg in groups I (n=9) and II (n=8), respectively. Normal saline (0.1 ml/kg) was injected in group III (n=8). The dogs were monitored for 48 h, and venous blood samples were collected prior to (baseline) and at intervals of 0.5, 1, 2, 4, 6, 8, 12, 24 and 48 h subsequent to the treatments. The white blood cell (WBC), platelet counts, and hematocrit (Hct) values were recorded. Platelet closure times were determined, using collagen/epinephrine (CEPI) and collagen/adenosine diphosphate (CADP) cartridges. Within 0.5 h after the endotoxin application baseline WBC and platelet counts (mean +/-SD) decreased significantly (p<0.001) to 2000 +/- 500 and 1850 +/- 200 cells/microl or 69.000 +/- 12.500 and 27.000 +/- 6.400 cells/microl in groups I and II, respectively. Platelet counts remained low during the first 1-48 h, but the WBC count was high at the 8th-48th h, in groups I and II, compared with baselines (p<0.001). After the application of the endotoxin, Hct values increased from baseline values of 37 +/- 3 or 39 +/- 2% to 48 +/- 2 or 51 +/- 3%, within 1 h (p<0.001), in groups I and II, respectively. Hct values in group II were notably higher (p<0.001) than those of group I, during the 2nd-48th h. Hematological parameters and closure times did not differ significantly throughout the study in group III. Baseline closure time ranged from 79 +/- 5 seconds (s) to 86 +/- 5 s for CADP and 144 +/- 13 s to 159 +/- 14 s for CEPI in all dogs (n=25). At 0.5 h after the endotoxin, the closure times of CADP as well as CEPI declined to 62 +/- 6 s and 76 +/- 8 s in group I (p<0.001) and 57 +/- 5 s and 75 +/- 6 s in group II (p<0.001). Afterwards, closure time prolonged to the levels of 280 +/- 8 s (CADP) and 294 +/- 5 s (CEPI) by 48 h (p<0.001) in group II, but returned to the baseline limit in group I. In conclusion, our results show that the shortened closure times may serve as a very early diagnostic sign of endotoxemia, prolonged closure times however may be used as an index for the severity of endotoxemia.
本研究旨在评估血小板功能分析仪（PFA - 100）测定的血小板封闭时间在犬内毒素血症中的诊断重要性。分别以0.02 mg/kg或1 mg/kg的剂量给I组（n = 9）和II组（n = 8）的犬静脉注射一次大肠杆菌内毒素。III组（n = 8）注射生理盐水（0.1 ml/kg）。对犬进行48小时监测，并在治疗前（基线）以及治疗后0.5、1、2、4、6、8、12、24和48小时采集静脉血样。记录白细胞（WBC）、血小板计数和血细胞比容（Hct）值。使用胶原/肾上腺素（CEPI）和胶原/二磷酸腺苷（CADP）检测卡测定血小板封闭时间。在内毒素注射后0.5小时内，I组和II组的基线WBC和血小板计数（平均值±标准差）显著下降（p<0.001），分别降至2000±500和1850±200个/微升或69000±12500和27000±6400个/微升。与基线相比，I组和II组在最初1 - 48小时血小板计数持续较低，但在第8 - 48小时WBC计数较高（p<0.001）。在内毒素注射后，I组和II组的Hct值在1小时内分别从基线值37±3%或39±2%增至48±2%或51±3%（p<0.001）。在第2 - 48小时，II组的Hct值显著高于I组（p<0.001）。III组在整个研究过程中血液学参数和封闭时间无显著差异。所有犬（n = 25）的CADP基线封闭时间为79±5秒（s）至86±5 s，CEPI为144±13 s至159±14 s。内毒素注射后0.5小时，I组CADP和CEPI的封闭时间分别降至62±6 s和76±8 s（p<0.001），II组降至57±5 s和75±6 s（p<0.001）。之后，II组在48小时时封闭时间延长至280±8 s（CADP）和294±5 s（CEPI）（p<0.001），而I组恢复至基线水平。总之，我们的结果表明，缩短的封闭时间可能是内毒素血症的一个非常早期的诊断标志，然而延长的封闭时间可作为内毒素血症严重程度的一个指标。
