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临床健康猫的旋转血栓弹力图(ROTEM)参考值。

Reference values for rotational thromboelastometry (ROTEM) in clinically healthy cats.

作者信息

Marly-Voquer Charlotte, Riond Barbara, Jud Schefer Rahel, Kutter Annette P N

机构信息

Section of Anesthesiology, Equine Department, Vetsuisse Faculty of the University of Zurich, Zurich, Switzerland.

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

出版信息

J Vet Emerg Crit Care (San Antonio). 2017 Mar;27(2):185-192. doi: 10.1111/vec.12584. Epub 2017 Feb 6.

Abstract

OBJECTIVE

To establish reference intervals for rotational thromboelastometry (ROTEM) using feline blood.

DESIGN

Prospective study.

SETTING

University teaching hospital.

ANIMALS

Twenty-three clinically healthy cats between 1 and 15 years.

INTERVENTION

For each cat, whole blood was collected via jugular or medial saphenous venipuncture, and blood was placed into a serum tube, a tube containing potassium-EDTA, and tubes containing 3.2% sodium citrate. The tubes were maintained at 37°C for a maximum of 30 minutes before coagulation testing.

MEASUREMENTS AND MAIN RESULTS

ROTEM tests included the EXTEM, INTEM, FIBTEM, and APTEM assays. In addition, prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen concentration (Clauss method) were analyzed for each cat. Reference intervals for ROTEM were calculated using the 2.5-97.5 percentile for each parameter, and correlation with the standard coagulation profile was performed. Compared to people, clinically healthy cats had similar values for the EXTEM and INTEM assays, but had lower plasma fibrinogen concentrations (0.9-2.2 g/L), resulting in weaker maximum clot firmness (MCF, 3-10 mm) in the FIBTEM test. In 18 cats, maximum lysis (ML) values in the APTEM test were higher than in the EXTEM test, which seems unlikely to have occurred in the presence of aprotinin. It is possible that the observed high maximum lysis values were due to clot retraction rather than true clot lysis. Further studies will be required to test this hypothesis.

CONCLUSIONS

Cats have a weaker clot in the FIBTEM test, but have a similar clot strength to human blood in the other ROTEM assays, which may be due to a stronger contribution of platelets compared to that found in people. In cats, careful interpretation of the results to diagnose hyperfibrinolysis is advised, especially with the APTEM test, until further data are available.

摘要

目的

使用猫血建立旋转血栓弹力图(ROTEM)的参考区间。

设计

前瞻性研究。

地点

大学教学医院。

动物

23只年龄在1至15岁之间的临床健康猫。

干预措施

对每只猫,通过颈静脉或内侧隐静脉穿刺采集全血,并将血液分别放入血清管、含乙二胺四乙酸钾的试管以及含3.2%柠檬酸钠的试管中。在进行凝血检测前,将试管在37°C下最多保存30分钟。

测量指标及主要结果

ROTEM检测包括EXTEM、INTEM、FIBTEM和APTEM检测。此外,对每只猫分析凝血酶原时间、活化部分凝血活酶时间、凝血酶时间和纤维蛋白原浓度(Clauss法)。使用每个参数的第2.5至97.5百分位数计算ROTEM的参考区间,并与标准凝血指标进行相关性分析。与人类相比,临床健康猫的EXTEM和INTEM检测值相似,但血浆纤维蛋白原浓度较低(0.9 - 2.2 g/L),导致FIBTEM检测中的最大血凝块硬度(MCF,3 - 10 mm)较弱。在18只猫中,APTEM检测中的最大溶解(ML)值高于EXTEM检测,在存在抑肽酶的情况下似乎不太可能出现这种情况。观察到的高最大溶解值可能是由于血凝块回缩而非真正的血凝块溶解。需要进一步研究来验证这一假设。

结论

猫在FIBTEM检测中血凝块较弱,但在其他ROTEM检测中血凝块强度与人类血液相似,这可能是由于与人类相比血小板的作用更强。对于猫,在有更多数据之前,建议谨慎解读结果以诊断高纤维蛋白溶解症,尤其是在APTEM检测中。

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