Hurcombe S D A, Toribio R E, Slovis N M, Saville W J, Mudge M C, Macgillivray K, Frazer M L
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA.
J Vet Intern Med. 2009 Mar-Apr;23(2):335-43. doi: 10.1111/j.1939-1676.2009.0275.x. Epub 2009 Feb 4.
Disorders of calcium regulation are frequently found in humans with critical illness, yet limited information exists in foals with similar conditions including septicemia. The purpose of this study was to determine whether disorders of calcium exist in septic foals, and to determine any association with survival.
Blood concentrations of ionized calcium (Ca(2+)) and magnesium (Mg(2+)) will be lower in septic foals with concomitant increases in parathyroid hormone (PTH), calcitonin (CT), and parathyroid-related peptide (PTHrP) compared with healthy foals. The magnitude of these differences will be negatively associated with survival.
Eighty-two septic, 40 sick nonseptic, and 24 healthy foals of <or=7 days were included.
Prospective, observational study. Blood was collected at initial examination for analysis. Foals with positive blood culture or sepsis score >or=14 were considered septic. Foals with disease other than sepsis and healthy foals were used as controls. Hormone concentrations were measured with validated immunoassays.
Septic foals had decreased Ca(2+) (5.6 versus 6.1 mg/dL, P < .01) and increased serum PTH (16.2 versus 3.2 pmol/L, P < .05), and phosphorus concentrations (7.1 versus 6.3 mg/dL, P < .01). No differences in serum Mg(2+), PTHrP, and CT concentrations were found. Nonsurviving septic foals (n = 42/82) had higher PTH concentrations (41.1 versus 10.7 pmol/L, P < .01) than survivors (n = 40/82).
Septic foals were more likely to have disorders of calcium regulation compared with healthy foals, where hyperparathyroidemia was associated with nonsurvival.
钙调节紊乱在危重症患者中很常见，但在患有类似疾病（包括败血症）的幼驹中，相关信息有限。本研究的目的是确定败血症幼驹是否存在钙紊乱，并确定其与生存的任何关联。
与健康幼驹相比，患有败血症的幼驹血中离子钙（Ca(2+)）和镁（Mg(2+)）浓度会降低，同时甲状旁腺激素（PTH）、降钙素（CT）和甲状旁腺相关肽（PTHrP）会升高。这些差异的程度与生存呈负相关。
纳入了82匹患有败血症、40匹患病但非败血症以及24匹年龄≤7天的健康幼驹。
前瞻性观察研究。在初次检查时采集血液进行分析。血培养阳性或败血症评分≥14的幼驹被视为患有败血症。患有除败血症以外疾病的幼驹和健康幼驹作为对照。使用经过验证的免疫测定法测量激素浓度。
患有败血症的幼驹Ca(2+)降低（5.6对6.1mg/dL，P<.01），血清PTH升高（16.2对3.2pmol/L，P<.05），磷浓度升高（7.1对6.3mg/dL，P<.01）。血清Mg(2+)、PTHrP和CT浓度未发现差异。未存活的败血症幼驹（n = 42/82）的PTH浓度（41.1对10.7pmol/L，P<.01）高于存活的幼驹（n = 40/82）。
与健康幼驹相比，患有败血症的幼驹更易出现钙调节紊乱，其中甲状旁腺功能亢进与死亡相关。
