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住院新生马驹肝脏酶活性升高的临床意义

Clinical implications of high liver enzyme activities in hospitalized neonatal foals.

作者信息

Haggett Emily F, Magdesian K Gary, Kass Philip H

机构信息

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.

出版信息

J Am Vet Med Assoc. 2011 Sep 1;239(5):661-7. doi: 10.2460/javma.239.5.661.

Abstract

OBJECTIVE

To determine whether high liver enzyme activities were negatively associated with outcome in sick neonatal foals as compared with foals that did not have high liver enzyme activities.

DESIGN

Retrospective case-control study.

ANIMALS

147 foals < 30 days old with high γ-glutamyltransferase activity, high sorbitol dehydrogenase activity, or both (case foals) and 263 foals < 30 days old with γ-glutamyltransferase and sorbitol dehydrogenase activities within reference limits (control foals).

PROCEDURES

Medical records were reviewed for information on signalment, physical examination findings, and results of hematologic and serum biochemical analyses performed at the time of admission to a veterinary medical teaching hospital.

RESULTS

Case foals were significantly more likely to die or be euthanized, compared with control foals (odds ratio, 2.22; 95% confidence interval, 1.28 to 3.85). Case foals were significantly more likely than control foals to have sepsis, and septic foals were significantly less likely to survive than were nonseptic foals. For case foals, other factors associated with a greater likelihood of nonsurvival were higher anion gap and higher logarithm of aspartate aminotransferase activity. When sepsis status was controlled for, the presence of high liver enzyme activities was not significantly associated with outcome.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that high liver enzyme activities were common in sick neonatal foals, especially foals with sepsis. Foals with high liver enzyme activities were more likely to be septic, and septic foals were less likely to survive than were foals without sepsis. However, high liver enzyme activities alone were not a useful negative prognostic indicator.

摘要

目的

与肝酶活性未升高的新生驹相比,确定肝酶活性升高是否与患病新生驹的预后呈负相关。

设计

回顾性病例对照研究。

动物

147匹年龄小于30日龄、γ-谷氨酰转移酶活性升高、山梨醇脱氢酶活性升高或两者均升高的驹(病例组驹),以及263匹年龄小于30日龄、γ-谷氨酰转移酶和山梨醇脱氢酶活性在参考范围内的驹(对照组驹)。

方法

查阅兽医教学医院收治时的病历,获取有关特征、体格检查结果以及血液学和血清生化分析结果的信息。

结果

与对照组驹相比,病例组驹死亡或实施安乐死的可能性显著更高(比值比,2.22;95%置信区间,1.28至3.85)。病例组驹患败血症的可能性显著高于对照组驹,且患败血症的驹存活的可能性显著低于未患败血症的驹。对于病例组驹,与非存活可能性增加相关的其他因素包括更高的阴离子间隙和更高的天冬氨酸氨基转移酶活性对数。当控制败血症状态时,肝酶活性升高与预后无显著相关性。

结论及临床意义

结果表明,肝酶活性升高在患病新生驹中很常见,尤其是患败血症的驹。肝酶活性升高的驹更易患败血症,且患败血症的驹比未患败血症的驹存活可能性更低。然而,单纯肝酶活性升高并非有用的不良预后指标。

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