Cortellini S, Pelligand L, Syme H, Chang Y M, Adamantos S
Clinical Sciences and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.
Comparative Biomedical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK.
J Vet Intern Med. 2015 Nov-Dec;29(6):1595-602. doi: 10.1111/jvim.13638. Epub 2015 Sep 29.
Neutrophil gelatinase-associated lipocalin (NGAL) is an early indicator of acute kidney injury (AKI) in dogs and its use has not been evaluated in dogs with sepsis.
Fifteen dogs with sepsis requiring laparotomy (study dogs) and 10 dogs undergoing surgery for intervertebral disc disease (control dogs).
To determine whether NGAL increases in dogs with sepsis undergoing emergency laparotomy and whether it is correlated with development of AKI and survival.
Longitudinal study conducted at a referral teaching hospital. Serum neutrophil gelatinase-associated lipocalin (sNGAL), urinary NGAL normalized to urinary creatinine concentration (UNCR), and serum creatinine concentration were measured at 4 time points (admission, after anesthesia, and 24 and 48 hours postsurgery). Development of AKI (increase in serum creatinine concentration of 0.3 mg/dL) and in-hospital mortality were recorded. Linear mixed-model analysis was employed to assess differences between groups over time. Mann-Whitney U-test was performed for comparison of continuous variables between groups and Chi square or Fisher's exact tests were used to assess correlation between discrete data.
Serum NGAL and UNCR were significantly higher in study dogs across all time points (P = .007 and P < .001, respectively) compared with controls. Urinary NGAL normalized to creatinine in the study group was not significantly different between survivors (n = 12) and nonsurvivors (n = 3). Dogs that received hydroxyethyl starch had significantly higher UNCR across all time points (P = .04) than those that did not.
DISCUSSION-CONCLUSION: Serum neutrophil gelatinase-associated lipocalin and UNCR are increased in dogs with sepsis requiring emergency laparotomy. Additional studies are needed to evaluate its role as a marker of AKI in this population.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是犬急性肾损伤（AKI）的早期指标，但其在脓毒症犬中的应用尚未得到评估。
15只需要剖腹手术的脓毒症犬（研究犬）和10只接受椎间盘疾病手术的犬（对照犬）。
确定急诊剖腹手术的脓毒症犬的NGAL是否升高，以及它是否与AKI的发生和生存相关。
在一家转诊教学医院进行纵向研究。在4个时间点（入院时、麻醉后、术后24小时和48小时）测量血清中性粒细胞明胶酶相关脂质运载蛋白（sNGAL）、尿肌酐浓度标准化的尿NGAL（UNCR）和血清肌酐浓度。记录AKI的发生（血清肌酐浓度升高0.3mg/dL）和院内死亡率。采用线性混合模型分析评估组间随时间的差异。采用Mann-Whitney U检验比较组间连续变量，采用卡方检验或Fisher精确检验评估离散数据之间的相关性。
与对照组相比，研究犬在所有时间点的血清NGAL和UNCR均显著更高（分别为P = 0.007和P < 0.001）。研究组中，幸存者（n = 12）和非幸存者（n = 3）的尿肌酐标准化尿NGAL无显著差异。接受羟乙基淀粉的犬在所有时间点的UNCR均显著高于未接受者（P = 0.04）。
讨论-结论：需要急诊剖腹手术的脓毒症犬的血清中性粒细胞明胶酶相关脂质运载蛋白和UNCR升高。需要进一步研究以评估其在该人群中作为AKI标志物的作用。
