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犬巴贝斯虫急性感染的预后标志物

Prognostic Markers in Acute Babesia canis Infections.

作者信息

Eichenberger R M, Riond B, Willi B, Hofmann-Lehmann R, Deplazes P

机构信息

Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

出版信息

J Vet Intern Med. 2016 Jan-Feb;30(1):174-82. doi: 10.1111/jvim.13822. Epub 2016 Jan 4.

Abstract

BACKGROUND

Canine babesiosis, caused by Babesia canis, is a prevalent and clinically relevant disease in Europe. Severe acute babesiosis is characterized by a high mortality but prognosis is not always correlated with clinical signs nor with the level of parasitemia.

OBJECTIVE

This study evaluated prognostic markers associated with poor outcomes in acute Babesia canis infections.

ANIMALS AND METHODS

We compared the results of routine laboratory profiles, hand-held lactate and glucose analyzer, and the acute phase response in 2 groups of naturally infected dogs (7 survivors and 8 nonsurvivors). Samples were collected at the time of first admission and before any treatment. Subsequently, the course of prognostic markers was followed in 3 dogs experimentally inoculated with B. canis.

RESULTS

Nonsurvivors showed significantly higher concentrations of lactate, triglycerides and phosphate and lower hematocrit, leukocyte counts, total serum protein concentrations, and thrombocyte counts when compared to survivors. All nonsurvivors (8/8) had hyperlactatemia, whereas most survivors (6/7) had values within the reference range. All survivors had leucocyte counts within the reference range, unlike the nonsurvivors, which showed leukopenia. During the course of acute babesiosis, the variables serum lactate, triglyceride, and phosphate concentrations, and thrombocyte count only exceeded a prognostic threshold during acute crisis.

CONCLUSIONS AND CLINICAL IMPORTANCE

Poor outcome in acute B. canis infection is indicated by changes in the laboratory profile. Intensive care should be considered for dogs presenting with moderate anemia, severe thrombocytopenia, mild to moderate leukopenia, hyperlactatemia, moderately increased serum phosphate, and triglyceride concentrations, and moderately decreased total serum protein concentrations.

摘要

背景

由犬巴贝斯虫引起的犬巴贝斯虫病在欧洲是一种常见且具有临床相关性的疾病。严重急性巴贝斯虫病的特点是死亡率高,但预后并不总是与临床症状或寄生虫血症水平相关。

目的

本研究评估了与急性犬巴贝斯虫感染不良预后相关的预后标志物。

动物与方法

我们比较了两组自然感染犬(7只存活犬和8只非存活犬)的常规实验室检查结果、手持式乳酸和葡萄糖分析仪检测结果以及急性期反应。样本在首次入院时且未进行任何治疗前采集。随后,对3只经实验接种犬巴贝斯虫的犬进行了预后标志物病程的跟踪。

结果

与存活犬相比,非存活犬的乳酸、甘油三酯和磷酸盐浓度显著更高,而血细胞比容、白细胞计数、总血清蛋白浓度和血小板计数更低。所有非存活犬(8/8)均有高乳酸血症,而大多数存活犬(6/7)的值在参考范围内。所有存活犬的白细胞计数均在参考范围内,与非存活犬不同,非存活犬表现为白细胞减少。在急性巴贝斯虫病病程中,血清乳酸、甘油三酯和磷酸盐浓度以及血小板计数仅在急性危机期间超过预后阈值。

结论及临床意义

实验室检查结果的变化表明急性犬巴贝斯虫感染预后不良。对于出现中度贫血、严重血小板减少、轻度至中度白细胞减少、高乳酸血症、血清磷酸盐和甘油三酯浓度中度升高以及总血清蛋白浓度中度降低的犬,应考虑进行重症监护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a323/4913656/1112a591edae/JVIM-30-174-g001.jpg

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