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患有慢性肝病犬的血栓弹力图检查

Thromboelastography in Dogs with Chronic Hepatopathies.

作者信息

Fry W, Lester C, Etedali N M, Shaw S, DeLaforcade A, Webster C R L

机构信息

Massachusetts Veterinary Referral Hospital, Woburn, MA.

Ocean State Veterinary Specialists, East Greenwich Rhode Island.

出版信息

J Vet Intern Med. 2017 Mar;31(2):419-426. doi: 10.1111/jvim.14639. Epub 2017 Jan 18.

Abstract

BACKGROUND

The coagulation status of dogs with liver disease is difficult to predict using conventional coagulation testing.

HYPOTHESIS/OBJECTIVES: To evaluate thromboelastography (TEG) results and associations with conventional coagulation results and indicators of disease severity and prognosis in dogs with chronic hepatopathies (CH).

ANIMALS

Twenty-one client-owned dogs.

METHODS

Dogs with CH were prospectively (10 dogs) and retrospectively (11 dogs) enrolled from 2008 to 2014. Kaolin-activated TEG was performed and compared with reference intervals by t-tests or Mann-Whitney tests. Correlation coefficients for TEG results and conventional coagulation and clinicopathologic results were determined. Significance was set at P < .05.

RESULTS

Dogs with CH had significant increases in R (5.30 min vs 4.33 min), K (3.77 min vs 2.11 min), and LY30 (4.77% vs 0.68%) and decreased angles (55.3° vs 62.4°). G value defined 9 of 21, 7 of 21, and 5 of 21 dogs as normocoagulable, hypercoagulable, and hypocoagulable, respectively. G and MA were correlated with fibrinogen (r = 0.68, 0.83), prothrombin time (PT; r = -0.51, -0.53), and activated partial thromboplastin time (aPTT; r = -0.50, -0.50). K was correlated with PT (r = 0.75) and protein C activity (r = -0.92). Angle was correlated with aPTT (r = -0.63). Clinical score was correlated with PT (r = 0.60), MA (r = -0.53), and R (r = -0.47). Dogs with hyperfibrinolysis (LY30 > 3.04%; 5 of 21) had significantly higher serum transaminase activities. Dogs with portal hypertension had significantly lower G, MA, and angle and prolonged, K, R, and PT.

CONCLUSIONS AND CLINICAL RELEVANCE

Dogs with CH have variable TEG results. Negative prognostic indicators in CH correlate with hypocoagulable parameters on TEG. Hyperfibrinolysis in dogs with CH is associated with high disease activity.

摘要

背景

使用传统凝血检测难以预测肝病犬的凝血状态。

假设/目的:评估慢性肝病(CH)犬的血栓弹力图(TEG)结果及其与传统凝血结果、疾病严重程度指标和预后的相关性。

动物

21只客户拥有的犬。

方法

2008年至2014年对CH犬进行前瞻性(10只犬)和回顾性(11只犬)纳入研究。进行高岭土激活的TEG检测,并通过t检验或曼-惠特尼检验与参考区间进行比较。确定TEG结果与传统凝血及临床病理结果的相关系数。显著性设定为P < 0.05。

结果

CH犬的R(5.30分钟对4.33分钟)、K(3.77分钟对2.11分钟)和LY30(4.77%对0.68%)显著增加,角度减小(55.3°对62.4°)。G值将21只犬中的9只、7只和5只分别定义为正常凝血、高凝和低凝。G和MA与纤维蛋白原(r = 0.68,0.83)、凝血酶原时间(PT;r = -0.51,-0.53)和活化部分凝血活酶时间(aPTT;r = -0.50,-0.50)相关。K与PT(r = 0.75)和蛋白C活性(r = -0.92)相关。角度与aPTT(r = -0.63)相关。临床评分与PT(r = 0.60)、MA(r = -0.53)和R(r = -0.47)相关。纤维蛋白溶解亢进(LY30 > 3.04%;21只中有5只)的犬血清转氨酶活性显著更高。门静脉高压的犬G、MA和角度显著更低,K、R和PT延长。

结论及临床意义

CH犬的TEG结果各异。CH中的不良预后指标与TEG上的低凝参数相关。CH犬的纤维蛋白溶解亢进与高疾病活动度相关。

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