Johnston Kimberly, Holcombe Susan J, Hauptman Joe G
Department of Large Animal Clinical Sciences, Michigan State University, College of Veterinary Medicine, East Lansing, MI 48824, USA.
Vet Surg. 2007 Aug;36(6):563-7. doi: 10.1111/j.1532-950X.2007.00305.x.
To determine the relationship between plasma lactate concentration and colonic viability and survival in horses with >or=360 degrees volvulus of the ascending colon.
Retrospective study.
Horses (n=73) with >or=360 degrees volvulus of the ascending colon.
Medical records (January 2000-November 2005) of all horses examined for colic at Michigan State University Veterinary Teaching Hospital were reviewed. Horses were included only if plasma lactate concentration was measured preoperatively and a diagnosis of >or=360 degrees volvulus of the ascending colon was confirmed by surgery or necropsy. Non-survivors were only included if the ascending colon was evaluated histopathologically. Logistic regression analysis was used to model the relationship between lactate, colonic viability, and survival.
Of 73 horses, 61 were discharged. Mean (+/-SD) plasma lactate concentration was significantly lower in survivors (2.98+/-2.53 mmol/L) compared with non-survivors (9.48+/-5.22 mmol/L; odds ratio [OR]=1.628, 95% confidence limit [CI]=1.259-2.105). Plasma lactate concentration was significantly lower in horses with a viable colon (3.30+/-2.85 mmol/L) compared with horses with a non-viable colon (9.1+/-6.09 mmol/L; OR=1.472, 95% CI=1.173-1.846). Plasma lactate concentration <6.0 mmol/L had a sensitivity of 84% and a specificity 83% for predicting horse survival.
Our results demonstrate a strong association between plasma lactate concentration at the time of hospital admission and outcome in horses with >or=360 degrees volvulus of the ascending colon.
Plasma lactate concentration may help predict colonic viability and horse survival after ascending colon volvulus in horses.
确定升结肠发生360度及以上扭转的马匹血浆乳酸浓度与结肠活力及存活率之间的关系。
回顾性研究。
升结肠发生360度及以上扭转的马匹（n = 73）。
查阅密歇根州立大学兽医教学医院2000年1月至2005年11月间所有因腹痛接受检查的马匹的病历。仅纳入术前测量血浆乳酸浓度且经手术或尸检确诊为升结肠360度及以上扭转的马匹。仅在对升结肠进行组织病理学评估时才纳入非存活马匹。采用逻辑回归分析来建立乳酸、结肠活力和存活率之间的关系模型。
73匹马中，61匹出院。与非存活马匹（9.48±5.22 mmol/L；优势比[OR]=1.628，95%置信区间[CI]=1.259 - 2.105）相比，存活马匹的平均（±标准差）血浆乳酸浓度（2.98±2.53 mmol/L）显著更低。与结肠无活力的马匹（9.1±6.09 mmol/L；OR = 1.472，95% CI = 1.173 - 1.846）相比，结肠有活力的马匹血浆乳酸浓度显著更低。血浆乳酸浓度<6.0 mmol/L对预测马匹存活的敏感度为84%，特异度为83%。
我们的结果表明，入院时血浆乳酸浓度与升结肠发生360度及以上扭转的马匹的预后密切相关。
血浆乳酸浓度可能有助于预测马匹升结肠扭转后的结肠活力和马匹存活率。
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