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地塞米松对马静息血乳酸浓度的影响。

Effect of Dexamethasone on Resting Blood Lactate Concentrations in Horses.

作者信息

Mizen K, Woodman J, Boysen S R, Wagg C, Greco-Otto P, Léguillette R, Roy M-F

机构信息

Northside Veterinary Clinic, Lethbridge, AB, Canada.

Alpine Pet Hospital, Calgary, AB, Canada.

出版信息

J Vet Intern Med. 2017 Jan;31(1):164-169. doi: 10.1111/jvim.14630. Epub 2016 Dec 25.

DOI:10.1111/jvim.14630
PMID:28019037
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5259638/
Abstract

BACKGROUND

Blood lactate concentration is a marker of tissue perfusion and helps guide therapeutic interventions in critically ill horses. In both humans and dogs, administration of corticosteroids can increase blood lactate concentration, leading to type B hyperlactatemia. This effect could be a consequence of the impact of corticosteroids on glucose metabolism.

OBJECTIVES

To investigate the effects of daily IM dexamethasone administration on blood lactate and glucose concentrations in horses.

ANIMALS

Nine healthy adult horses.

METHODS

A randomized, blinded, controlled, cross-over study design was used. Horses were randomly assigned to 1 of 2 groups, either receiving 0.05 mg/kg of dexamethasone IM or an equivalent volume of saline, daily for 7 days. Blood was collected to determine lactate and glucose concentrations at baseline, 2 hours after the daily injections and 24 hours after the last injection.

RESULTS

Dexamethasone treatment had a statistically significant effect on lactate (P = .006) and glucose (P = .033) concentrations. The least squares mean lactate concentration was 0.93 mmol/L (95% CI: 0.87-0.99) in the dexamethasone group compared to 0.71 mmol/L (95% CI: 0.70-0.73) for the saline group. A positive relationship between blood lactate and glucose concentrations was identified, with a 0.07 mmol/L (95% CI: 0.05-0.09) increase in lactate concentration per unit increase in glucose (P < .0001) concentration.

CONCLUSIONS AND CLINICAL IMPORTANCE

Dexamethasone induces statistically significant increases in blood lactate and glucose concentrations in healthy horses. Awareness of the potential for corticosteroids to induce type B hyperlactatemia might be important in the management of critically ill horses receiving dexamethasone.

摘要

背景

血乳酸浓度是组织灌注的一个指标,有助于指导对危重病马的治疗干预。在人类和犬类中,给予皮质类固醇均可增加血乳酸浓度,导致B型高乳酸血症。这种效应可能是皮质类固醇对葡萄糖代谢产生影响的结果。

目的

研究每日肌肉注射地塞米松对马血乳酸和葡萄糖浓度的影响。

动物

9匹健康成年马。

方法

采用随机、盲法、对照、交叉研究设计。将马随机分为2组,每组接受以下处理之一,即每日肌肉注射0.05mg/kg地塞米松或等量生理盐水,持续7天。在基线、每日注射后2小时以及最后一次注射后24小时采集血液,以测定乳酸和葡萄糖浓度。

结果

地塞米松治疗对乳酸(P = 0.006)和葡萄糖(P = 0.033)浓度有统计学显著影响。地塞米松组的最小二乘平均乳酸浓度为0.93mmol/L(95%CI:0.87 - 0.99),而生理盐水组为0.71mmol/L(95%CI:0.70 - 0.73)。血乳酸和葡萄糖浓度之间呈正相关,葡萄糖浓度每增加一个单位,乳酸浓度增加0.07mmol/L(95%CI:0.05 - 0.09)(P < 0.0001)。

结论及临床意义

地塞米松可使健康马的血乳酸和葡萄糖浓度出现统计学显著升高。对于接受地塞米松治疗的危重病马,认识到皮质类固醇诱发B型高乳酸血症的可能性在管理中可能很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/ef2ded77de7b/JVIM-31-164-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/84cf39403db8/JVIM-31-164-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/bfeb1b5ead94/JVIM-31-164-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/ef2ded77de7b/JVIM-31-164-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/84cf39403db8/JVIM-31-164-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/bfeb1b5ead94/JVIM-31-164-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdd6/5259638/ef2ded77de7b/JVIM-31-164-g003.jpg

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Blood lactate measurement and interpretation in critically ill equine adults and neonates.成年和新生重症马的血乳酸测定与解读
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