Stokol Tracy, Erb Hollis N, De Wilde Lisa, Tornquist Susan J, Brooks Marjory
Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
Vet Clin Pathol. 2005 Dec;34(4):375-82. doi: 10.1111/j.1939-165x.2005.tb00064.x.
Fibrin(ogen) degradation products (FDPs) and D-dimer are sensitive indicators of excessive fibrinolysis due to disseminated intravascular coagulation (DIC) in dogs. To the authors' knowledge, latex-agglutination-based plasma FDP and D-dimer assays have not been validated for use in horses.
To determine: 1) sensitivity and specificity of latex agglutination serum and plasma FDP and D-dimer assays for diagnosis of DIC; and 2) their prognostic value in horses with severe colic.
At hospital admission and 24 hours later, blood was collected from 30 healthy horses and 20 horses with severe colic. Horses fulfilling predefined laboratory criteria of DIC were enrolled, and their data were subcategorized by survival for analysis. Platelet counts were determined and coagulation panel testing was performed. Serum and plasma FDP concentrations were measured using separate latex agglutination kits. Plasma D-dimer concentration was measured using 3 latex agglutination kits and a card immunofiltration test. Test sensitivity and specificity results were determined for healthy horses and those with colic. Median test values were compared between colic survivors and nonsurvivors to evaluate the prognostic usefulness of all tests.
Performance characteristics varied among assays and kit suppliers. The FDP assays had low sensitivity (<40%), whereas the most accurate D-dimer kit had 50% sensitivity and 97% specificity. High D-dimer concentration was the third most common hemostatic abnormality in horses with colic. Median antithrombin (AT) activity was significantly lower and activated partial thromboplastin time (aPTT) was significantly longer in nonsurvivors than survivors.
Commercial latex-agglutination D-dimer assays might prove useful as adjunctive tests for the diagnosis of DIC in horses with severe colic; however FDP assays are invalid for this purpose. Low AT activity and prolonged aPTT at admission are associated with a poor prognosis in this patient population.
纤维蛋白（原）降解产物（FDPs）和D - 二聚体是犬类因弥散性血管内凝血（DIC）导致过度纤溶的敏感指标。据作者所知，基于乳胶凝集的血浆FDP和D - 二聚体检测方法尚未在马匹中得到验证。
确定：1）乳胶凝集血清和血浆FDP及D - 二聚体检测方法对DIC诊断的敏感性和特异性；2）它们在患有严重腹痛的马匹中的预后价值。
在入院时和24小时后，从30匹健康马匹和20匹患有严重腹痛的马匹采集血液。纳入符合DIC预定义实验室标准的马匹，并根据生存情况对其数据进行分类分析。测定血小板计数并进行凝血指标检测。使用单独的乳胶凝集试剂盒测量血清和血浆FDP浓度。使用3种乳胶凝集试剂盒和一种卡片免疫过滤试验测量血浆D - 二聚体浓度。确定健康马匹和腹痛马匹的检测敏感性和特异性结果。比较腹痛存活者和非存活者的检测中位数，以评估所有检测的预后实用性。
不同检测方法和试剂盒供应商的性能特征有所不同。FDP检测方法敏感性较低（<40%），而最准确的D - 二聚体试剂盒敏感性为50%，特异性为97%。高D - 二聚体浓度是患有腹痛的马匹中第三常见的止血异常。非存活者的抗凝血酶（AT）活性中位数显著低于存活者，活化部分凝血活酶时间（aPTT）显著长于存活者。
商业乳胶凝集D - 二聚体检测方法可能被证明是诊断患有严重腹痛马匹DIC的辅助检测方法；然而，FDP检测方法在此目的上无效。入院时低AT活性和延长的aPTT与该患者群体的不良预后相关。
