Aitken Maia R, Stefanovski Darko, Southwood Louise L
Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
Vet Surg. 2019 Feb;48(2):143-151. doi: 10.1111/vsu.13133. Epub 2018 Nov 29.
To determine serum amyloid A (SAA) concentrations in the postoperative (PO) colic horse and its association with PO complications and infection.
Prospective case series.
Fifty-one horses after colic surgery.
Blood samples from horses undergoing exploratory celiotomy were analyzed for quantitative SAA and fibrinogen concentrations and for neutrophil count at days 0, 1, 2, and 4-6 and at hospital discharge.
Complications developed in 35 (69%) horses and included PO colic (n = 13, 25%), PO reflux (n = 11, 22%), intravenous catheter (IVC) complications (n = 11, 22%), low-grade fever (n = 11, 22%); surgical site infection (SSI; n = 9, 18%), high-grade fever (n = 7, 14%), and diarrhea (n = 4, 8%). There was an association between day 2 SAA and PO colic (P = .004), diarrhea (P = .042), IVC complications (P = .008), and PO reflux (P = .008) as well as day 4-6 SAA and PO colic (P = .004) and diarrhea (P = .018). Discharge SAA concentration was associated with SSI (P = .001). Fibrinogen concentrations at days 4-6 and at discharge were associated with PO colic (P = .003), diarrhea (P = .004), IVC complications (P = .002), and PO reflux (P = .023). No differences were seen in SAA, fibrinogen, or neutrophils between horses with PO infection vs those with non-infection-associated complications.
Serum amyloid A was markedly increased in the PO period in all horses but did not differ between PO infection and noninfection complications. The amount of inflammation associated with PO colic and colic surgery was high and may have affected the predictive value of SAA for early PO infection.
Although increases occurred earlier, measurement of SAA with a point-of-care analyzer may not be a more sensitive indicator of infection in the early PO colic horse than fibrinogen concentration. Serum amyloid A may help detect SSI in the late PO period.
测定术后患急腹症马的血清淀粉样蛋白A（SAA）浓度，并探讨其与术后并发症及感染的关系。
前瞻性病例系列研究。
51匹接受急腹症手术的马。
对接受剖腹探查术的马在术后第0、1、2、4 - 6天及出院时采集血样，分析SAA、纤维蛋白原定量浓度及中性粒细胞计数。
35匹（69%）马出现并发症，包括术后急腹症（n = 13，25%）、术后反流（n = 11，22%）、静脉导管（IVC）并发症（n = 11，22%）、低热（n = 11，22%）；手术部位感染（SSI；n = 9，18%）、高热（n = 7，14%）及腹泻（n = 4，8%）。术后第2天的SAA与术后急腹症（P = 0.004）、腹泻（P = 0.042）、IVC并发症（P = 0.008）及术后反流（P = 0.008）相关，术后第4 - 6天的SAA与术后急腹症（P = 0.004）及腹泻（P = 0.018）相关。出院时的SAA浓度与SSI相关（P = 0.001）。术后第4 - 6天及出院时的纤维蛋白原浓度与术后急腹症（P = 0.003）、腹泻（P = 0.004）、IVC并发症（P = 0.002）及术后反流（P = 0.023）相关。术后感染的马与非感染相关并发症的马在SAA、纤维蛋白原或中性粒细胞方面无差异。
所有马在术后期间SAA均显著升高，但术后感染与非感染并发症之间无差异。与术后急腹症及急腹症手术相关的炎症程度较高，可能影响了SAA对早期术后感染的预测价值。
尽管SAA升高出现得更早，但对于早期术后患急腹症的马，使用即时检验分析仪检测SAA可能并不比检测纤维蛋白原浓度对感染更敏感。血清淀粉样蛋白A可能有助于在术后晚期检测手术部位感染。
