Jitpean Supranee, Pettersson Ann, Höglund Odd V, Holst Bodil Ström, Olsson Ulf, Hagman Ragnvi
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, SE-750 07, Sweden.
BMC Vet Res. 2014 Nov 28;10:273. doi: 10.1186/s12917-014-0273-9.
Sepsis is a serious and potentially life-threatening condition and early diagnosis and appropriate treatment is crucial for survival. Pyometra is one of the most common diseases in intact female dogs. The disease often leads to sepsis (systemic inflammatory response syndrome, SIRS, caused by infection). Diagnostic markers for detecting sepsis are gaining increasing interest in veterinary medicine. Acute phase proteins (APPs) such as C-reactive protein (CRP) are useful for detecting systemic inflammation in dogs. Serum amyloid A (SAA) is another major APP in dogs that is not yet as widely used. Albumin is regarded as a negative APP and has earlier been evaluated for prediction of prognosis in septic dogs. The aim of the present study was to determine SAA, CRP and albumin concentrations in dogs with sepsis and pyometra and to evaluate whether these inflammatory markers are associated with length of postoperative hospitalization.
Thirty-one surgically treated bitches with pyometra were included, whereof 23 septic (SIRS-positive) and eight non-septic (SIRS-negative). Albumin concentrations were analyzed by routine automated methods. SAA and CRP analyses were performed with previously validated commercially available assays (ELISA and immunoturbidimetric).Mean (± SE) serum concentrations of SAA were significantly higher in septic (130.8 ± 8.0 mg/L) compared to non-septic bitches (88.5 ± 12.5 mg/L). Using a cut-off value for SAA of 109.07 mg/L (n = 31 bitches), the sensitivity and specificity for detecting sepsis was 74% and 50%, respectively. Serum albumin concentrations were not significantly different in septic compared to non-septic bitches (mean ± SE, 25 ± 1 g/L and 26 ± 1 g/L, respectively). CRP concentrations were also not significantly different in septic (mean ± SE 225.6 ± 16.0 mg/L) compared to non-septic bitches (mean ± SE, 176.0 ± 27.1 mg/L). None of these inflammatory markers were associated with the outcome as measured by length of hospitalization.
SAA concentrations were increased in dogs with sepsis induced by pyometra and may be useful as an adjunctive diagnostic marker for sepsis. To evaluate the full potential of SAA as a marker for sepsis also in other diseases, further studies are warranted.
脓毒症是一种严重且可能危及生命的病症，早期诊断和恰当治疗对生存至关重要。子宫蓄脓是未绝育母犬最常见的疾病之一。该疾病常导致脓毒症（由感染引起的全身炎症反应综合征，SIRS）。检测脓毒症的诊断标志物在兽医学中越来越受到关注。急性期蛋白（APPs）如C反应蛋白（CRP）可用于检测犬类的全身炎症。血清淀粉样蛋白A（SAA）是犬类中另一种主要的APP，但尚未得到广泛应用。白蛋白被视为一种负急性期蛋白，此前已对其在脓毒症犬预后预测方面进行了评估。本研究的目的是测定患有脓毒症和子宫蓄脓的犬的SAA、CRP和白蛋白浓度，并评估这些炎症标志物是否与术后住院时间相关。
纳入了31只接受手术治疗的子宫蓄脓母犬，其中23只患有脓毒症（SIRS阳性），8只无脓毒症（SIRS阴性）。白蛋白浓度通过常规自动化方法进行分析。SAA和CRP分析采用先前验证过的市售检测方法（ELISA和免疫比浊法）。与无脓毒症的母犬（88.5±12.5mg/L）相比，患有脓毒症的母犬（130.8±8.0mg/L）的SAA平均（±SE）血清浓度显著更高。以SAA的临界值109.07mg/L（n=31只母犬）进行检测，检测脓毒症的敏感性和特异性分别为74%和50%。与无脓毒症的母犬相比，患有脓毒症的母犬的血清白蛋白浓度无显著差异（平均±SE，分别为25±1g/L和26±1g/L）。与无脓毒症的母犬相比，患有脓毒症的母犬的CRP浓度也无显著差异（平均±SE，分别为225.6±16.0mg/L和176.0±27.1mg/L）。这些炎症标志物均与以住院时间衡量的预后无关。
子宫蓄脓诱导的脓毒症犬的SAA浓度升高，可能作为脓毒症的辅助诊断标志物。为了评估SAA作为脓毒症标志物在其他疾病中的全部潜力，还需要进一步研究。
