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患有绞痛的马匹的腹膜和血浆D-乳酸浓度

Peritoneal and plasma D-lactate concentrations in horses with colic.

作者信息

Yamout Sawsan Z, Nieto Jorge E, Beldomenico Pablo M, Dechant Julie E, leJeune Sarah, Snyder Jack R

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA 95616, USA.

出版信息

Vet Surg. 2011 Oct;40(7):817-24. doi: 10.1111/j.1532-950X.2011.00859.x. Epub 2011 Aug 4.

Abstract

OBJECTIVE

To evaluate the association between peritoneal fluid and plasma d-lactate concentration with variables used in the diagnosis and prognosis of horses with colic.

ANIMALS

Clinically healthy horses (n=6) and 90 horses with colic.

STUDY DESIGN

Prospective cross-sectional study.

METHODS

D-lactate concentration was determined in peritoneal fluid and plasma of all horses. Information on other blood and peritoneal fluid variables, signalment, results from the physical examination, outcome, need for surgery, lesion location, and type was retrieved from medical records.

RESULTS

Peritoneal D-lactate concentration was strongly correlated with plasma D-lactate concentration (r=0.71; P<.001). Peritoneal and plasma D-lactate concentrations were positively correlated with peritoneal (r=0.8; P<.001) and plasma L-lactate (r=0.33; P=.001) concentrations, respectively. Peritoneal D-lactate concentration was negatively correlated with survival to discharge (U=430.5; P<.001). Median peritoneal D-lactate concentration of horses with septic peritonitis (455.2 μmol/L) and horses with gastrointestinal rupture (599.5 μmol/L) were higher compared with horses with nonstrangulating obstructions (77.7 μmol/L). A cut-off concentration of peritoneal D-lactate of 116.6 μmol/L had a sensitivity of 0.813 and a specificity of 0.651 to differentiate between nonstrangulating and strangulating obstructions.

CONCLUSIONS

Peritoneal D-lactate concentration may be more useful for identifying horses with strangulating obstructions (high sensitivity, low probability of a false negative) than to ruling out strangulating obstruction (moderate specificity, high probability of a false positive).

摘要

目的

评估马属动物患急腹症时,腹腔液和血浆中D-乳酸浓度与用于诊断和预后的变量之间的关联。

动物

临床健康马匹(n = 6)和90匹患急腹症的马匹。

研究设计

前瞻性横断面研究。

方法

测定所有马匹腹腔液和血浆中的D-乳酸浓度。从病历中获取其他血液和腹腔液变量、特征、体格检查结果、预后、手术需求、病变位置和类型等信息。

结果

腹腔D-乳酸浓度与血浆D-乳酸浓度密切相关(r = 0.71;P <.001)。腹腔和血浆D-乳酸浓度分别与腹腔(r = 0.8;P <.001)和血浆L-乳酸(r = 0.33;P =.001)浓度呈正相关。腹腔D-乳酸浓度与出院存活率呈负相关(U = 430.5;P <.001)。与非绞窄性肠梗阻马匹(77.7 μmol/L)相比,患有化脓性腹膜炎的马匹(455.2 μmol/L)和胃肠破裂的马匹(599.5 μmol/L)的腹腔D-乳酸浓度中位数更高。腹腔D-乳酸浓度截断值为116.6 μmol/L时,区分非绞窄性和绞窄性肠梗阻的灵敏度为0.813,特异度为0.651。

结论

腹腔D-乳酸浓度对于识别绞窄性肠梗阻马匹(高灵敏度,低假阴性概率)可能比排除绞窄性肠梗阻(中等特异度,高假阳性概率)更有用。

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