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血清淀粉样蛋白A在猫败血症诊断中的应用

Serum amyloid A in the diagnosis of feline sepsis.

作者信息

Troìa Roberta, Gruarin Marta, Foglia Armando, Agnoli Chiara, Dondi Francesco, Giunti Massimo

机构信息

Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy.

出版信息

J Vet Diagn Invest. 2017 Nov;29(6):856-859. doi: 10.1177/1040638717722815. Epub 2017 Jul 28.

Abstract

Systemic inflammatory response syndrome (SIRS) and sepsis can be challenging to diagnose in cats. Retrospectively, we investigated the diagnostic and prognostic potential of serum amyloid A (SAA), a major feline acute-phase protein (APP), in a population of critically ill cats with SIRS related to trauma or sepsis. A total of 56 SIRS cats (trauma n = 27; sepsis n = 29) were included and compared with healthy controls ( n = 18). SAA concentration was significantly increased in SIRS cats compared to controls, confirming its potential for the detection of systemic inflammation in this species. Significantly higher values of SAA were detected in cats belonging to the sepsis group; however, according to the results of the receiver operating characteristic curve analysis, the value of using SAA (>81 mg/L) to discriminate septic cats was only moderate (AUC = 0.76). Additionally, cats with sepsis had significantly higher serum bilirubin concentrations and toxic neutrophil changes compared to the trauma group. Overall, 38 of 56 cats were survivors; 18 of 56 were non-survivors, with 83% of the non-survivors (15 of 18) belonging to the sepsis group. Serum bilirubin concentration, but not SAA, was able to predict outcome. Prospective studies are needed to assess the potential of SAA in the diagnosis of feline sepsis and outcome prediction.

摘要

全身炎症反应综合征(SIRS)和脓毒症在猫中可能难以诊断。我们进行了回顾性研究,调查了血清淀粉样蛋白A(SAA)这一主要的猫急性期蛋白(APP)在患有与创伤或脓毒症相关的SIRS的危重病猫群体中的诊断和预后潜力。总共纳入了56只患有SIRS的猫(创伤组n = 27;脓毒症组n = 29),并与健康对照(n = 18)进行比较。与对照组相比,SIRS猫的SAA浓度显著升高,证实了其在检测该物种全身炎症方面的潜力。在脓毒症组的猫中检测到的SAA值显著更高;然而,根据受试者工作特征曲线分析结果,使用SAA(>81 mg/L)来区分脓毒症猫的价值仅为中等(AUC = 0.76)。此外,与创伤组相比,脓毒症猫的血清胆红素浓度显著更高,且出现毒性中性粒细胞变化。总体而言,56只猫中有38只存活;56只中有18只未存活,其中83%的未存活猫(18只中的15只)属于脓毒症组。血清胆红素浓度而非SAA能够预测预后。需要进行前瞻性研究来评估SAA在猫脓毒症诊断和预后预测中的潜力。

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