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比较听诊、超声检查和声学胃肠监测生物传感器评估健康马匹的胃肠动力:一项随机、盲法、对照交叉原则性验证研究。

Assessing gastrointestinal motility in healthy horses comparing auscultation, ultrasonography and an acoustic gastrointestinal surveillance biosensor: a randomised, blinded, controlled crossover proof of principle study.

作者信息

VanderBroek A R, Reef V B, Aitken M R, Stefanovski D, Southwood L L

机构信息

Department of Clinical Studies, New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, Pennsylvania, USA.

出版信息

Equine Vet J. 2019 Mar;51(2):246-251. doi: 10.1111/evj.12990. Epub 2018 Aug 6.

Abstract

BACKGROUND

Auscultation and ultrasonography are noninvasive techniques used to assess gastrointestinal motility in horses. Recently, noninvasive acoustic gastrointestinal surveillance (AGIS) biosensors evaluating intestinal motility have been validated in humans.

OBJECTIVES

To compare AGIS to auscultation and ultrasonography for detecting decreased motility after xylazine administration.

STUDY DESIGN

Randomised, blinded, controlled cross-over proof of principle study.

METHODS

Six healthy horses were evaluated under fasted and nonfasted conditions and randomly assigned to receive treatment with 0.4 mg/kg xylazine or an equivalent volume of 0.9% NaCl intravenously. After a 48-h washout period, the process was repeated with the alternate treatment. Motility was assessed pre and posttreatment. Borborygmi were assessed in each abdominal quadrant and graded on a scale of 0-3, with 3 being continuous borborygmi. Duodenal, jejunal and caecal contractions were assessed ultrasonographically in consistent locations. Four AGIS biosensors were applied in standardised locations (duodenum, caecum, ventral midline, right dorsal colon). The biosensors measure acoustic signals and data were recorded in transport metric. Data were analysed using cross-classified multilevel random effects logistic regression including area under the receiver operator characteristic curve (AUC ROC). Sensitivity, specificity and accuracy were calculated for each modality.

RESULTS

All three modalities detected a reduction in gastrointestinal motility following xylazine administration with AUC ROC being 0.85, 0.84 and 0.86 for auscultation, ultrasonography and AGIS respectively. The sensitivity, specificity and accuracy for auscultation was 88, 71 and 75%; for ultrasonography was 67, 63 and 64%; and for AGIS was 69, 70 and 70%, respectively.

MAIN LIMITATIONS

The study was performed in normal healthy horses and application of this device to clinical patients warrants further investigation.

CONCLUSIONS

In this proof of principle study, AGIS was able to discriminate between horses given xylazine from those given 0.9% NaCl with comparable accuracy as auscultation and ultrasonography. The Summary is available in Spanish - see Supporting Information.

摘要

背景

听诊和超声检查是用于评估马胃肠道蠕动的非侵入性技术。最近,评估肠道蠕动的非侵入性声学胃肠道监测(AGIS)生物传感器已在人类中得到验证。

目的

比较AGIS与听诊和超声检查在检测赛拉嗪给药后蠕动减少方面的效果。

研究设计

随机、盲法、对照交叉原理验证研究。

方法

对6匹健康马在禁食和非禁食条件下进行评估,并随机分配接受静脉注射0.4mg/kg赛拉嗪或等量的0.9%氯化钠治疗。经过48小时的洗脱期后,用另一种治疗方法重复该过程。在治疗前后评估蠕动情况。在每个腹部象限评估肠鸣音,并按0-3级进行分级,3级为持续肠鸣音。在一致的位置超声评估十二指肠、空肠和盲肠的收缩情况。在标准化位置(十二指肠、盲肠、腹中线、右背结肠)应用4个AGIS生物传感器。生物传感器测量声学信号,并以传输指标记录数据。使用交叉分类多水平随机效应逻辑回归分析数据,包括受试者操作特征曲线下面积(AUC ROC)。计算每种方法的敏感性、特异性和准确性。

结果

所有三种方法都检测到赛拉嗪给药后胃肠道蠕动减少,听诊、超声检查和AGIS的AUC ROC分别为0.85、0.84和0.86。听诊的敏感性、特异性和准确性分别为88%、71%和75%;超声检查为67%、63%和64%;AGIS为69%、70%和70%。

主要局限性

该研究是在正常健康马身上进行的,将该设备应用于临床患者需要进一步研究。

结论

在这项原理验证研究中,AGIS能够以与听诊和超声检查相当的准确性区分给予赛拉嗪的马和给予0.9%氯化钠的马。总结内容有西班牙语版本 - 见支持信息。

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