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用于犬糖尿病酮症酸中毒检测与治疗的毛细血管血3-β-羟基丁酸测定的准确性

Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis.

作者信息

Bresciani Francesca, Pietra Marco, Corradini Sara, Giunti Massimo, Fracassi Federico

机构信息

Department of Veterinary Medical Sciences, University of Bologna, 40126 Bologna, Italy.

出版信息

J Vet Sci. 2014;15(2):309-16. doi: 10.4142/jvs.2014.15.2.309. Epub 2014 Mar 21.

Abstract

In human medicine, diagnosis of diabetic ketoacidosis (DKA) is usually based on measurement of capillary 3-β-hydroxybutyrate (3-HB) with a hand held ketone sensor. This study was conducted to determine if measurement of capillary 3-HB could be useful for the diagnosis and monitoring of canine DKA. Fifteen dogs with diabetic ketosis and 10 with DKA were evaluated. Paired measurements of 3-HB of capillary and venous blood samples were analysed by the electrochemical sensor and reference method. Use of capillary 3-HB measurement during DKA management was then evaluated through simultaneous measurements of capillary 3-HB, urinary AcAc and venous blood gas analysis. Good agreement between capillary and venous 3-HB measurement was detected by the electrochemical sensor and reference method. Monitoring treatment of DKA revealed a significant correlation between capillary 3-HB and acidosis markers, while no significant correlation was observed between AcAc and acidosis markers. A cut-off value of capillary blood 3-HB > 3.8 mmol/L for diagnosis of DKA resulted in 70% and 92% sensitivity and specificity. The electrochemical sensor accurately measures 3-HB concentration in both capillary and venous blood samples, is accurate in diagnosing canine DKA, and appears to reflect the patient's metabolic status during DKA treatment.

摘要

在人类医学中,糖尿病酮症酸中毒(DKA)的诊断通常基于使用手持式酮类传感器测量毛细血管中的3-β-羟基丁酸(3-HB)。本研究旨在确定测量毛细血管中的3-HB是否有助于犬类DKA的诊断和监测。对15只患有糖尿病酮症和10只患有DKA的犬进行了评估。通过电化学传感器和参考方法对毛细血管和静脉血样本中的3-HB进行配对测量。然后通过同时测量毛细血管中的3-HB、尿乙酰乙酸(AcAc)和静脉血气分析,评估在DKA管理过程中使用毛细血管3-HB测量的情况。电化学传感器和参考方法检测到毛细血管和静脉3-HB测量之间具有良好的一致性。DKA治疗监测显示,毛细血管3-HB与酸中毒标志物之间存在显著相关性,而AcAc与酸中毒标志物之间未观察到显著相关性。诊断DKA时,毛细血管血3-HB>3.8 mmol/L的截断值导致敏感性和特异性分别为70%和92%。电化学传感器能准确测量毛细血管和静脉血样本中的3-HB浓度,在诊断犬类DKA方面准确,并且似乎能反映DKA治疗期间患者的代谢状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82fb/4087234/4973a2babd90/jvs-15-309-g001.jpg

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