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犬类被巴勒斯坦蝰蛇咬伤后的心律失常与血清心肌肌钙蛋白

Cardiac arrhythmias and serum cardiac troponins in Vipera palaestinae envenomation in dogs.

作者信息

Segev G, Ohad D G, Shipov A, Kass P H, Aroch I

机构信息

School of Veterinary Medicine, the Hebrew University of Jerusalem, Israel, Rehovot, Israel.

出版信息

J Vet Intern Med. 2008 Jan-Feb;22(1):106-13. doi: 10.1111/j.1939-1676.2007.0026.x.

Abstract

BACKGROUND

Vipera palaestinae is responsible for most poisonous envenomations in people and animals in Israel. Cardiac arrhythmias were reported in a retrospective study of V. palaestinae envenomations in dogs.

HYPOTHESIS

Cardiac arrhythmias in V. palaestinae-envenomed dogs are associated with myocardial injury reflected by increased serum concentrations of cardiac troponins (cTns).

ANIMALS

Forty-eight client-owned dogs envenomed by V. palaestinae.

METHODS

Blood sampling (serum biochemistry and cTns, CBC, and coagulation tests) and electrocardiography were performed periodically up to 72 hours postenvenomation. Cardiac rhythm strips were assessed blindly for the presence and type of arrhythmias.

RESULTS

Serum cTn-T and cTn-I concentrations were increased in 25% (n = 12) and 65% (n = 31) of the dogs at least once during hospitalization, respectively. Arrhythmias were identified in 29% (n = 14) of the dogs. Dogs with increased cTn-T had a significantly higher occurrence of arrhythmias (58 versus 19%), and higher resting heart rate upon admission and within the following 24 hours. Dogs with increased serum cTn-T concentrations were hospitalized for a significantly (P= .001) longer period compared to those with normal serum cTn-T concentrations.

CONCLUSIONS AND CLINICAL RELEVANCE

Dogs envenomed by V. palaestinae appear to sustain some degree of myocardial injury, as reflected by increased serum cTn concentrations and by the occurrence of arrhythmias. The latter should alert clinicians to a potentially ongoing cardiac injury. An increase in cTn-T may be of clinical relevance and indicate a cardiac injury in V. palaestinae envenomations in dogs.

摘要

背景

巴勒斯坦蝰蛇是以色列人和动物中毒性咬伤的主要原因。在一项关于巴勒斯坦蝰蛇咬伤犬类的回顾性研究中报告了心律失常。

假设

被巴勒斯坦蝰蛇咬伤的犬类出现心律失常与心肌损伤有关,心肌损伤表现为血清心肌肌钙蛋白(cTn)浓度升高。

动物

48只被巴勒斯坦蝰蛇咬伤的客户自养犬。

方法

在咬伤后72小时内定期进行采血(血清生化、cTn、全血细胞计数和凝血试验)和心电图检查。对心电图记录条进行盲法评估,以确定心律失常的存在和类型。

结果

住院期间,分别有25%(n = 12)和65%(n = 31)的犬血清cTn-T和cTn-I浓度至少有一次升高。29%(n = 14)的犬被发现有心律失常。cTn-T升高的犬心律失常发生率显著更高(58%对19%),入院时及随后24小时内静息心率更高。与血清cTn-T浓度正常的犬相比,血清cTn-T浓度升高的犬住院时间显著更长(P = .001)。

结论及临床意义

被巴勒斯坦蝰蛇咬伤的犬似乎受到了一定程度的心肌损伤,这表现为血清cTn浓度升高和心律失常的发生。后者应提醒临床医生注意可能正在发生的心脏损伤。cTn-T升高可能具有临床意义,提示犬被巴勒斯坦蝰蛇咬伤时存在心脏损伤。

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