Torrente Carlos, Manzanilla Edgar G, Bosch Luis, Fresno Laura, Rivera Del Alamo Montserrat, Andaluz Anna, Saco Yolanda, Ruiz de Gopegui Rafael
Servei d'Emergències i Cures Intensives FHCV-UAB, Facultat de Veterinària de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain.
Departament de Medicina i Cirurgia Animals, Facultat de Veterinària de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Vet Emerg Crit Care (San Antonio). 2015 Sep-Oct;25(5):611-9. doi: 10.1111/vec.12340. Epub 2015 Jul 14.
To investigate the diagnostic and prognostic value over time of plasma iron compared with the inflammatory markers albumin, C-reactive protein (CRP), and fibrinogen in dogs with systemic inflammatory response syndrome (SIRS).
Prospective observational study of sequentially enrolled dogs.
ICU of a veterinary teaching hospital.
One hundred and sixteen client-owned dogs: 54 dogs with SIRS or sepsis, 42 with focal inflammation, and 20 clinically healthy dogs.
Blood samples were obtained on admission in all study groups, and then on alternate days until discharge or death in both inflammation groups. On admission, dogs with SIRS had significantly lower plasma iron (65 ± 5.8 μg/dL, P = 0.001) concentrations than dogs with focal inflammation (89.5 ± 6.2 μg/dL, P = 0.001). Plasma iron, albumin, and CRP effectively discriminated the SIRS/sepsis group from those presenting with focal inflammation with areas under the curve for the receiver operating curves of 0.679, 0.834, and 0.704, respectively. The admission values for these variables did not discriminate survivors from nonsurvivors within the SIRS/sepsis group. However, the magnitude of increase in iron concentration and the decrease in CRP concentration from admission to hospital discharge was higher in survivors than in nonsurvivors within the SIRS/septic group (22.8 vs. 2.51 μg/dL, respectively, P = 0.021 for iron; -67.1 vs. -4.1 mg/L, respectively, P = 0.002 for CRP), resulting in iron and CRP concentrations at hospital discharge for survivors similar to those in the focal inflammation group.
Hypoferremia is a sensitive marker of systemic inflammation in dogs. In this study, the increase in iron concentrations during the hospitalization period of SIRS/septic dogs was associated with a better prognosis, suggesting that plasma iron in combination with CRP and albumin concentrations might be used to monitor dogs with inflammatory disease processes.
研究与炎症标志物白蛋白、C反应蛋白(CRP)和纤维蛋白原相比,血浆铁随时间推移对患有全身炎症反应综合征(SIRS)的犬的诊断和预后价值。
对连续纳入的犬进行前瞻性观察研究。
一家兽医教学医院的重症监护病房。
116只客户拥有的犬:54只患有SIRS或脓毒症的犬,42只患有局部炎症的犬,以及20只临床健康的犬。
所有研究组在入院时采集血样,然后在两个炎症组中每隔一天采集一次,直至出院或死亡。入院时,患有SIRS的犬的血浆铁浓度(65±5.8μg/dL,P = 0.001)显著低于患有局部炎症的犬(89.5±6.2μg/dL,P = 0.001)。血浆铁、白蛋白和CRP能有效区分SIRS/脓毒症组和局部炎症组,其受试者操作曲线下面积分别为0.679、0.834和0.704。这些变量的入院值在SIRS/脓毒症组中无法区分存活者和非存活者。然而,SIRS/脓毒症组中存活者从入院到出院时铁浓度的升高幅度和CRP浓度的降低幅度高于非存活者(铁分别为22.8 vs. 2.51μg/dL,P = 0.021;CRP分别为-67.1 vs. -4.1mg/L,P = 0.002),导致存活者出院时的铁和CRP浓度与局部炎症组相似。
低铁血症是犬全身炎症的敏感标志物。在本研究中,SIRS/脓毒症犬住院期间铁浓度的升高与较好的预后相关,提示血浆铁联合CRP和白蛋白浓度可用于监测患有炎症性疾病过程的犬。