Sikora Monika, Król Jarosław, Nowak Marcin, Stefaniak Tadeusz, Aubertsson Gudmar, Kozdrowski Roland
Department of Reproduction and Clinic of Farm Animals, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Plac Grunwaldzkistreet 49, 50366, Wroclaw, Poland.
Department of Pathology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C. K. Norwidastreet 31, 50375, Wroclaw, Poland.
Acta Vet Scand. 2016 Sep 7;58(1):50. doi: 10.1186/s13028-016-0233-4.
Endometritis is a common problem in a broodmare practice, often leading to infertility. The diagnosis is based on several methods such as cytology, bacteriology and histopathology; however the outcome of these methods may be inconclusive even when used together. The objectives of this study were: (1) to investigate the usefulness of acute phase proteins as an additional diagnostic tool for diagnosis of subclinical endometritis in mares and (2) to evaluate the association between macroscopic changes in uterine flushes and inflammation of the uterus. Materials were collected from 53 Icelandic mares with subclinical endometritis. Endometrial swabs and uterine lavage for cytological and bacteriological examinations and two endometrial biopsies were taken. Blood samples were collected 12-24 h after ovulation to determine the concentrations of serum amyloid A and haptoglobin in the 53 subfertile mares and, for comparison, from 20 non-pregnant mares that later conceived.
Twenty-five mares were classified as positive for endometritis based on endometrial biopsy, which was used as the 'gold standard'. We observed a correlation between cloudy efflux in the lavage and (1) polymorphonuclear cell (PMN) infiltration of the endometrium (P = 0.031), (2) positive cytology in samples obtained by cotton swabs (P = 0.019) and uterine lavage (P = 0.011), and (3) positive microbiology from samples obtained by cotton swabs (P = 0.001) and uterine lavage (P = 0.047). The degree of agreement between PMN infiltration and positive cytology from samples taken by cotton swabs and uterine lavage was fair to moderate. We found no association between the concentration of acute phase proteins and infiltration of the endometrium by PMNs, or with positive results of cytological and microbiological examinations.
Measurement of serum amyloid A and haptoglobin was not proven useful for diagnosis of subclinical endometritis in Icelandic mares. Macroscopic changes in the fluid collected by lavage were not consistently indicative of infection, but when present they indicate inflammation in the uterus with a high probability.
子宫内膜炎是母马繁育实践中的常见问题，常导致不育。诊断基于多种方法，如细胞学、细菌学和组织病理学；然而，即使这些方法联合使用，其结果也可能不明确。本研究的目的是：（1）研究急性期蛋白作为母马亚临床子宫内膜炎额外诊断工具的实用性；（2）评估子宫冲洗液的宏观变化与子宫炎症之间的关联。从53匹患有亚临床子宫内膜炎的冰岛母马收集材料。采集子宫内膜拭子和子宫灌洗液用于细胞学和细菌学检查，并取两份子宫内膜活检样本。在排卵后12 - 24小时采集血样，以测定53匹不育母马血清淀粉样蛋白A和触珠蛋白的浓度，并与20匹后来受孕的未孕母马进行比较。
以子宫内膜活检作为“金标准”，25匹母马被归类为子宫内膜炎阳性。我们观察到灌洗液浑浊与以下情况之间存在相关性：（1）子宫内膜多形核细胞（PMN）浸润（P = 0.031）；（2）棉拭子样本（P = 0.019）和子宫灌洗液样本（P = 0.011）的细胞学阳性；（3）棉拭子样本（P = 0.001）和子宫灌洗液样本（P = 0.047）的微生物学阳性。棉拭子和子宫灌洗液样本的PMN浸润与细胞学阳性之间的一致性程度为中等。我们发现急性期蛋白浓度与子宫内膜PMN浸润之间，或与细胞学和微生物学检查阳性结果之间无关联。
血清淀粉样蛋白A和触珠蛋白的测定未被证明对冰岛母马亚临床子宫内膜炎的诊断有用。灌洗收集的液体中的宏观变化并非始终指示感染，但当出现时，它们很可能表明子宫存在炎症。
