Silverstein Deborah C, Montealegre Catalina, Shofer Frances S, Otto Cynthia M
Department of Clinical Studies, University of Pennsylvania Matthew J Ryan Veterinary Hospital, Philadelphia, PA 19104-6010, USA.
J Vet Emerg Crit Care (San Antonio). 2009 Oct;19(5):459-66. doi: 10.1111/j.1476-4431.2009.00457.x.
To determine the relationship between plasma vascular endothelial growth factor (VEGF) levels, severity of illness, and edema formation in critically ill dogs.
Prospective, observational, descriptive, clinical study.
University Teaching Hospital.
Twenty-eight dogs.
None.
Physical examination and multifrequency bioimpedance (MFBIA) measurements were performed daily on 28 critically ill dogs with evidence of severe inflammatory disease and compared with the corresponding plasma VEGF levels. The change in VEGF values and the relationship between MFBIA measurements and clinical evidence of edema were also examined. Eighteen dogs had a positive VEGF level, 12 dogs had clinical evidence of edema, and 7 dogs had both a positive VEGF level and clinical evidence of edema. There was no statistically significant correlation between VEGF levels and the presence of edema on physical examination (P=0.2). VEGF values were also evaluated with respect to WBC count, survival prediction index, presence of known sepsis, change in extracellular water, and outcome. No statistical relationship could be identified between VEGF levels in the blood of dogs with inflammatory disease and their survival prediction index (P=0.1), the WBC count (P=0.2), or presence of sepsis (P=0.2). Dogs with a VEGF level >70 pg/mL (n=3) were less likely to survive (P=0.04). Because of high variability within and between animals, conclusions regarding changes in MFBIA could not be made, suggesting that this technology requires further refinement and investigation in critically ill dogs.
A relationship between VEGF and clinically evident increased vascular permeability was not found in this study. Dogs with markedly elevated VEGF levels may be more likely to die, but further studies are needed to determine the diagnostic and prognostic value of VEGF in critically ill dogs.
确定重症犬血浆血管内皮生长因子（VEGF）水平、疾病严重程度与水肿形成之间的关系。
前瞻性、观察性、描述性临床研究。
大学教学医院。
28只犬。
无。
对28只患有严重炎症性疾病的重症犬每日进行体格检查和多频生物电阻抗（MFBIA）测量，并与相应的血浆VEGF水平进行比较。还检查了VEGF值的变化以及MFBIA测量值与水肿临床证据之间的关系。18只犬VEGF水平呈阳性，12只犬有水肿的临床证据，7只犬VEGF水平呈阳性且有水肿的临床证据。体格检查时VEGF水平与水肿的存在之间无统计学显著相关性（P = 0.2）。还根据白细胞计数、生存预测指数、已知脓毒症的存在、细胞外液变化和结局评估了VEGF值。在患有炎症性疾病的犬血液中，VEGF水平与其生存预测指数（P = 0.1）、白细胞计数（P = 0.2）或脓毒症的存在（P = 0.2）之间未发现统计学关系。VEGF水平>70 pg/mL的犬（n = 3）存活的可能性较小（P = 0.04）。由于动物内部和动物之间存在高度变异性，无法得出关于MFBIA变化的结论，这表明该技术在重症犬中需要进一步改进和研究。
本研究未发现VEGF与临床上明显的血管通透性增加之间存在关联。VEGF水平明显升高的犬可能更易死亡，但需要进一步研究以确定VEGF在重症犬中的诊断和预后价值。
