Brazzell Jennifer L, Borjesson Dori L
Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA.
Vet Clin Pathol. 2007 Mar;36(1):79-84. doi: 10.1111/j.1939-165x.2007.tb00186.x.
Current coagulation tests lack sensitivity and detect disseminated intravascular coagulation (DIC) only when it is severe. Measurement of antithrombin (AT) activity and D-dimer concentration permits early diagnosis and more precise classification of coagulopathies in some species.
The objectives of this study were to validate and determine the diagnostic utility of a chromogenic AT assay and an immunoturbidimetric D-dimer assay for the diagnosis of DIC in cats.
Citrated plasma samples were collected from 30 healthy cats, 30 ill cats, and 13 cats with cardiomyopathy. Partial thromboplastin time, prothrombin time, fibrin(ogen) degradation products, platelet concentration, and erythrocyte morphology were determined on all samples to document the presence or the absence of DIC. AT activity and D-dimer concentration were then measured.
The chromogenic AT assay was linear and precise. Mean AT activity was higher in ill cats and cats with cardiomyopathy compared with healthy cats, but the difference was only significant in ill cats (P = .003). Seven cats met the criteria for DIC. Of the cats with DIC, 2 had decreased AT activity, 1 had increased AT activity, and 4 had AT activities within normal limits. The immunoturbidimetric D-dimer assay did not appear to accurately measure feline D-dimer.
The chromogenic AT assay appeared to measure AT in cats but was not useful for the diagnosis of DIC. AT may be an acute phase reactant in cats. The immunoturbidimetric D-dimer assay was not useful for the diagnosis of DIC in cats.
目前的凝血检测缺乏敏感性,仅在弥散性血管内凝血(DIC)严重时才能检测到。抗凝血酶(AT)活性和D - 二聚体浓度的测定有助于某些物种凝血障碍的早期诊断和更精确的分类。
本研究的目的是验证并确定发色底物法测定AT活性和免疫比浊法测定D - 二聚体对猫DIC诊断的实用性。
采集30只健康猫、30只患病猫和13只患有心肌病的猫的枸橼酸盐血浆样本。对所有样本测定部分凝血活酶时间、凝血酶原时间、纤维蛋白(原)降解产物、血小板浓度和红细胞形态,以记录是否存在DIC。然后测量AT活性和D - 二聚体浓度。
发色底物法测定AT活性呈线性且精确。与健康猫相比,患病猫和患有心肌病的猫的平均AT活性更高,但差异仅在患病猫中显著(P = 0.003)。7只猫符合DIC标准。在患有DIC的猫中,2只AT活性降低,1只AT活性升高,4只AT活性在正常范围内。免疫比浊法测定D - 二聚体似乎不能准确测量猫的D - 二聚体。
发色底物法似乎可用于测定猫的AT活性,但对DIC诊断无用。AT可能是猫的一种急性期反应物。免疫比浊法测定D - 二聚体对猫DIC诊断无用。