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健康马匹、患有炎症性胃肠疾病的马匹以及疑似凝血障碍马匹的血栓弹力图检查

Thromboelastography in healthy horses and horses with inflammatory gastrointestinal disorders and suspected coagulopathies.

作者信息

Mendez-Angulo Jose L, Mudge Margaret C, Vilar-Saavedra Paulo, Stingle Nicole, Couto C Guillermo

机构信息

Department of Veterinary Clinical Sciences and Veterinary Teaching Hospital, The Ohio State University, Columbus, OH 43210, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2010 Oct;20(5):488-93. doi: 10.1111/j.1476-4431.2010.00576.x. Epub 2010 Sep 28.

Abstract

OBJECTIVES

To evaluate the use of citrated recalcified (nonactivated) thromboelastography (TEG) in healthy horses and horses with colitis and suspected coagulopathies.

DESIGN

Prospective, observational study conducted between October 2007 and June 2009.

SETTING

Veterinary Teaching Hospital.

ANIMALS

Forty-five healthy adult horses and 12 sick adult horses with colitis and prolonged prothrombin time (PT) or activated partial thromboplastin time (aPTT).

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Whole blood was collected on admission. Coagulation profile (PT, aPTT, platelet count, and fibrinogen concentration) and citrated recalcified whole blood TEG analysis (R-time [R], K-time [K], angle [α], maximum amplitude [MA], G value [G], lysis at 60 min [LY60]) were evaluated. Mean values (SD) for TEG parameters in healthy horses were: R=10.4 (3.1) minutes; K=3.5 (1.2) minutes; α=46.3 (11.0)°; MA=55.6 (5.1) mm; G=6,429 (1,341) dyn/cm², and LY60=5.1 (2.4)%. Mean coefficients of variation for intra-assay/interindividual variability in healthy horses were: R=4.7%/30.7%, K=4.8%/35.3%, α=4.4%/23.8%, MA=1.4%/9.3%, G=3.4%/20.8%, and LY60=13.1%/47.7%, respectively. Horses with colitis and prolonged PT and/or aPTT had longer mean values for R (P<0.001) and K (P<0.001), narrower mean α (P<0.001), decreased mean MA (P=0.001), and smaller mean G (P=0.02); changes consistent with hypocoagulability.

CONCLUSIONS

Citrated recalcified (nonactivated) TEG demonstrated changes consistent with hypocoagulability in horses with colitis that had preidentified coagulation abnormalities. This technique has high interindividual variability and low intra-assay variability. TEG may be useful for detecting hypocoagulable states in horses with colitis and suspected coagulopathies.

摘要

目的

评估枸橼酸盐再钙化(未激活)血栓弹力图(TEG)在健康马匹以及患有结肠炎和疑似凝血功能障碍马匹中的应用。

设计

2007年10月至2009年6月间进行的前瞻性观察性研究。

地点

兽医教学医院。

动物

45匹健康成年马以及12匹患有结肠炎且凝血酶原时间(PT)延长或活化部分凝血活酶时间(aPTT)延长的患病成年马。

干预措施

无。

测量指标及主要结果

入院时采集全血。评估凝血指标(PT、aPTT、血小板计数和纤维蛋白原浓度)以及枸橼酸盐再钙化全血TEG分析(反应时间[R]、凝固时间[K]、角度[α]、最大振幅[MA]、G值[G]、60分钟时的纤溶率[LY60])。健康马匹TEG参数的平均值(标准差)为:R = 10.4(3.1)分钟;K = 3.5(1.2)分钟;α = 46.3(11.0)°;MA = 55.6(5.1)毫米;G = 6429(1341)达因/平方厘米,LY60 = 5.1(2.4)%。健康马匹测定内/个体间变异的平均变异系数分别为:R = 4.7% / 30.7%,K = 4.8% / 35.3%,α = 4.4% / 23.8%,MA = 1.4% / 9.3%,G = 3.4% / 20.8%,LY60 = 13.1% / 47.7%。患有结肠炎且PT和/或aPTT延长的马匹R(P < 0.001)和K(P < 0.001)的平均值更长,α的平均角度更窄(P < 0.001),MA平均值降低(P = 0.001),G平均值更小(P = 0.02);这些变化与低凝状态一致。

结论

枸橼酸盐再钙化(未激活)TEG显示,患有结肠炎且已确定存在凝血异常的马匹出现了与低凝状态一致的变化。该技术个体间变异性高,测定内变异性低。TEG可能有助于检测患有结肠炎和疑似凝血功能障碍马匹的低凝状态。

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