Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
J Vet Intern Med. 2011 Mar-Apr;25(2):307-14. doi: 10.1111/j.1939-1676.2010.0673.x. Epub 2011 Feb 11.
Coagulopathies in horses with gastrointestinal disease are frequently identified and associated with morbidity and fatality.
Determine if thrombelastography (TEG) identifies abnormalities associated with lesion type, presence of systemic inflammatory response syndrome (SIRS), morbidity, and fatality more consistently than traditional coagulation testing.
One-hundred and one horses examined for gastrointestinal disease and 20 healthy horses.
TEG, tissue factor (TF)-TEG, and traditional coagulation panels parameters and percentages of horses with coagulopathies were compared for lesion type, presence of SIRS, complications, and survival.
Changes in individual parameters and increased incidence of coagulopathies were associated with fatality (R, P= .007; k-value [K], P= .004; clot lysis [CL]30, P= .037; CL60, P= .050; angle [Ang], P= .0003; maximum amplitude [MA], P= .006; lysis [Ly]30, P= .042; Ly60, P= .027; CI, P= .0004; ≥ 2 TEG coagulopathies, P= .013; ≥ 3 TEG coagulopathies, P= .038; TF-R, P= .037; TF-K, P= .004; TF-CL30, P < .0001; TF-CL60, P < .0001; TF-Ang, P= .005; TF-Ly30, P= .0002; TF-Ly60, P < .0001; TF-CI, P= .043; ≥ 1 TF-TEG coagulopathies, P= .003; ≥ 2 TF-TEG coagulopathies, P= .0004; prothrombin tme [PT], P < .0001; activated partial throboplastin time [aPTT], P= .021), inflammatory lesions (MA, P= .013; TF-CL30, P= .033; TF-CL60, P= .010; TF-Ly60, P= .011; ≥ 1 TF-TEG coagulopathy, P= .036; ≥ 2 TF-TEG coagulopathy, P= .0007; PT, P= .0005; fibrinogen, P= .019), SIRS (MA, P= .004; TF-CL30, P= .019; TF-CL60, P= .013; TF-Ly30, P= .020; TF-Ly60, P= .010; PT, P < .0001; aPTT, P= .032; disseminated intravascular coagulation, P= .005), and complications (ileus: aPTT, P= .020; diarrhea: TF-CL30, P= .040; TF-Ly30, P= .041; thrombophlebitis: ≥ 1 TF-TEG coagulopathy, P= .018; laminitis: MA, P= .004; CL60, P= .045; CI, P= .036; TF-MA, P= .019; TF-TEG CI, P= .019). Abnormalities in TEG and TF-TEG parameters were indicative of hypocoagulation and hypofibrinolysis.
TEG identifies changes in coagulation and fibrinolysis associated with lesion type, SIRS, morbidity, and fatality in horses with gastrointestinal disease.
患有胃肠道疾病的马经常出现凝血异常，并与发病率和死亡率相关。
确定血栓弹性描记术（TEG）是否比传统凝血检测更能一致地识别与病变类型、全身性炎症反应综合征（SIRS）、发病率和死亡率相关的异常。
101 匹接受胃肠道疾病检查的马和 20 匹健康马。
比较了 TEG、组织因子（TF）-TEG 和传统凝血面板参数以及凝血异常的马的百分比，以确定病变类型、SIRS、并发症和存活率。
个体参数的变化和凝血异常的发生率增加与死亡率相关（R，P=.007；K 值[K]，P=.004；凝块溶解[CL]30，P=.037；CL60，P=.050；角度[Ang]，P=.0003；最大振幅[MA]，P=.006；溶解[Ly]30，P=.042；Ly60，P=.027；CI，P=.0004；≥2 项 TEG 凝血异常，P=.013；≥3 项 TEG 凝血异常，P=.038；TF-R，P=.037；TF-K，P=.004；TF-CL30，P<.0001；TF-CL60，P<.0001；TF-Ang，P=.005；TF-Ly30，P=.0002；TF-Ly60，P<.0001；TF-CI，P=.043；≥1 项 TF-TEG 凝血异常，P=.003；≥2 项 TF-TEG 凝血异常，P=.0004；凝血酶原时间[PT]，P<.0001；活化部分凝血活酶时间[aPTT]，P=.021）、炎症性病变（MA，P=.013；TF-CL30，P=.033；TF-CL60，P=.010；TF-Ly60，P=.011；≥1 项 TF-TEG 凝血异常，P=.036；≥2 项 TF-TEG 凝血异常，P=.0007；PT，P=.0005；纤维蛋白原，P=.019）、SIRS（MA，P=.004；TF-CL30，P=.019；TF-CL60，P=.013；TF-Ly30，P=.020；TF-Ly60，P=.010；PT，P<.0001；aPTT，P=.032；弥散性血管内凝血，P=.005）和并发症（肠梗阻：aPTT，P=.020；腹泻：TF-CL30，P=.040；TF-Ly30，P=.041；血栓性静脉炎：≥1 项 TF-TEG 凝血异常，P=.018；蹄叶炎：MA，P=.004；CL60，P=.045；CI，P=.036；TF-MA，P=.019；TF-TEG CI，P=.019）。TEG 和 TF-TEG 参数的异常表明存在低凝和低纤维蛋白溶解。
TEG 可识别与胃肠道疾病马的病变类型、SIRS、发病率和死亡率相关的凝血和纤维蛋白溶解变化。
