Radcliffe Rolfe M, Divers Thomas J, Fletcher Daniel J, Mohammed Hussni, Kraus Marc S
Department of Clinical Studies, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Jun;22(3):313-9. doi: 10.1111/j.1476-4431.2012.00744.x.
To evaluate changes in plasma cardiac troponin I (cTnI) and L-lactate (LLt) as prognostic indicators in horses undergoing emergency abdominal surgery.
Prospective observational study.
Veterinary teaching hospital.
Thirty-four horses undergoing emergency abdominal surgery.
Serial blood sampling during various times during hospitalization (hospital admission, and 12, 24, 48, and 72 h postoperatively) evaluating cTnI and LLt concentrations.
All horses required surgery for correction of a strangulating (n = 29) or nonstrangulating obstruction (n = 5) of the small or large intestine. Twenty-seven horses survived to discharge; 7 were euthanized either during (n = 1) or after (n = 6) surgery due to disease severity or systemic complications associated with the primary gastrointestinal lesion. Preoperative cTnI concentrations were increased above the normal reference interval in 24% of horses (8/34, median = 0.01 ng/mL, range = 0-12.23 ng/mL), whereas LLt concentrations were increased above the normal reference interval in 88% of horses (30/34, median = 3.37 mmol/L, range = 0.77-13.26 mmol/L). The LLt concentration was significantly higher (P < 0.05) in nonsurviving compared with surviving horses at admission, and at 24 and 72 hours postoperatively. No significant difference in the cTnI concentration was detected between groups at admission. However, the cTnI concentration was significantly higher (P<0.05) in nonsurviving compared with surviving horses at all time points postoperatively.
Measurement of both LLt and cTnI concentrations may provide information for prognostication in surgical colic horses. Marked increases in admission concentrations of LLt (median 7.56 mmol/L) and even moderate postoperative increases in cTnI concentration (median 0.97 ng/mL) may both indicate a poor prognosis in critically ill horses following abdominal surgery.
评估血浆心肌肌钙蛋白I（cTnI）和L-乳酸（LLt）作为接受急诊腹部手术马匹预后指标的变化。
前瞻性观察研究。
兽医教学医院。
34匹接受急诊腹部手术的马。
在住院期间的不同时间（入院时、术后12、24、48和72小时）进行系列采血，评估cTnI和LLt浓度。
所有马匹均因小肠或大肠绞窄性（n = 29）或非绞窄性梗阻（n = 5）而需要手术治疗。27匹马存活至出院；7匹马因疾病严重程度或与原发性胃肠道病变相关的全身并发症在手术期间（n = 1）或术后（n = 6）实施安乐死。24%的马匹（8/34，中位数 = 0.01 ng/mL，范围 = 0 - 12.23 ng/mL）术前cTnI浓度高于正常参考区间，而88%的马匹（30/34，中位数 = 3.37 mmol/L，范围 = 0.77 - 13.26 mmol/L）LLt浓度高于正常参考区间。入院时以及术后24和72小时，未存活马匹的LLt浓度显著高于存活马匹（P < 0.05）。入院时两组间cTnI浓度未检测到显著差异。然而，术后所有时间点未存活马匹的cTnI浓度显著高于存活马匹（P<0.05）。
LLt和cTnI浓度的测量可为患急腹症的手术马匹的预后提供信息。入院时LLt浓度显著升高（中位数7.56 mmol/L），甚至术后cTnI浓度适度升高（中位数0.97 ng/mL）均可能表明重症马匹腹部手术后预后不良。
