Department of Population Medicine, University of Guelph, Ontario N1G 2W1, Canada.
J Dairy Sci. 2010 Dec;93(12):5764-71. doi: 10.3168/jds.2010-3429.
The objective of this observational study was to investigate the risk factors for metritis, purulent vaginal discharge, and cytological endometritis. The hypothesis was that purulent vaginal discharge and cytological endometritis would have different risk factors because they represent distinct manifestations of uterine disease. Data generated from 1,363 Holstein cows (3 herds) enrolled in a randomized clinical trial were used. Calving history, periparturient disease incidence, and body condition score at calving and at 63 d in milk (DIM) were recorded. Serum nonesterified fatty acid concentration was measured once during the week before expected calving. Serum nonesterified fatty acid, β-hydroxybutyric acid, and haptoglobin (Hapto) concentrations were measured at 4 ± 3, 11 ± 3, and 18 ± 3 DIM. Serum progesterone concentration was measured at 21 ± 3, 35 ± 3, 49 ± 3, and 63 ± 3 DIM. Metritis was diagnosed by farm managers within the first 20 DIM using a standardized definition. Cows were examined at 35 ± 3 DIM by a veterinarian for purulent vaginal discharge (mucopurulent or worse vaginal discharge; Metricheck device) and cytological endometritis (≥ 6% polymorphonuclear cells on endometrial cytology; cytobrush device). Statistical analyses were performed using multivariable logistic regression models for each disease, accounting for the random effect of herd. Risk factors for metritis included increased nonesterified fatty acid prepartum (≥ 0.6 mmol/L), dystocia, retained placenta, and increased Hapto in the first week postpartum (≥ 0.8 g/L). Risk factors for purulent vaginal discharge included twinning, dystocia, metritis, and increased Hapto (≥ 0.8 g/L) in the first week postpartum. Risk factors for cytological endometritis included low body condition score at parturition (≤ 2.75), hyperketonemia (≥ 1,100 μmol/L), and increased Hapto (≥ 0.8 g/L) in the first week postpartum. These results support the hypothesis that some of the risk factors for purulent vaginal discharge and cytological endometritis are different, which supports that they are distinct manifestations of uterine disease.
本观察性研究旨在探讨子宫内膜炎、脓性阴道分泌物和细胞学子宫内膜炎的危险因素。假设脓性阴道分泌物和细胞学子宫内膜炎的危险因素不同，因为它们代表了子宫疾病的不同表现形式。使用了来自参加随机临床试验的 1363 头荷斯坦奶牛（3 个牛群）的数据。记录了产犊史、围产期疾病发生率以及产犊时和产犊后 63 天（DMI）的体况评分。在预计产犊前的一周内，单次测量血清非酯化脂肪酸浓度。在第 4 ± 3、11 ± 3 和 18 ± 3 DMI 时测量血清非酯化脂肪酸、β-羟丁酸和触珠蛋白（Hapto）浓度。在第 21 ± 3、35 ± 3、49 ± 3 和 63 ± 3 DMI 时测量血清孕酮浓度。产犊后 20 天内，农场经理根据标准化定义诊断子宫内膜炎。在第 35 ± 3 DMI 时，兽医使用 Metricheck 设备检查脓性阴道分泌物（脓性或更差的阴道分泌物），使用 cytobrush 设备检查细胞学子宫内膜炎（子宫内膜细胞学上≥6%的多形核细胞）。使用多变量逻辑回归模型对每种疾病进行分析，考虑到牛群的随机效应。子宫内膜炎的危险因素包括产前非酯化脂肪酸升高（≥0.6mmol/L）、难产、胎衣滞留和产后第一周 Hapto 升高（≥0.8g/L）。脓性阴道分泌物的危险因素包括双胎、难产、子宫内膜炎和产后第一周 Hapto 升高（≥0.8g/L）。细胞学子宫内膜炎的危险因素包括分娩时体况评分低（≤2.75）、酮血症（≥1100μmol/L）和产后第一周 Hapto 升高（≥0.8g/L）。这些结果支持了这样的假设，即脓性阴道分泌物和细胞学子宫内膜炎的一些危险因素不同，这支持了它们是子宫疾病不同表现形式的假设。
