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将对氧磷酶-1和丁酰胆碱酯酶活性与急性期蛋白相比在脓毒症犬中的诊断和预后价值进行评估,并根据急性患者生理和实验室评估评分进行分层。

The diagnostic and prognostic value of paraoxonase-1 and butyrylcholinesterase activities compared with acute-phase proteins in septic dogs and stratified by the acute patient physiologic and laboratory evaluation score.

作者信息

Torrente Carlos, Manzanilla Edgar G, Bosch Luis, Villaverde Cecilia, Pastor Josep, de Gopegui Rafael Ruiz, Tvarijonaviciute Asta

机构信息

Servei d'Emergències i Cures Intensives, Fundació Hospital Clínic Veterinari-UAB, Bellaterra, Spain.

Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain.

出版信息

Vet Clin Pathol. 2019 Dec;48(4):740-747. doi: 10.1111/vcp.12807. Epub 2019 Dec 1.

Abstract

BACKGROUND

Sepsis is a complex syndrome that involves an increased oxidative stress status and dysregulation of cholinergic neurotransmission. Paraoxonase-1 (PON-1) and butyrylcholinesterase (BChE) activities have been identified as significant biomarkers to monitor such disorders in human septic patients.

OBJECTIVE

We aimed to determine the diagnostic and prognostic value of PON-1 and BChE vs other traditional acute-phase proteins such as albumin (ALB) and C-reactive protein (CRP) in septic dogs.

METHODS

This prospective observational study included 20 dogs with a diagnosis of sepsis, 27 with low-grade systemic inflammation (LGSI), and 10 healthy dogs that served as controls. Plasma samples were obtained from all dogs for analysis on admission, and then every 24-48 hours until discharge or death in the septic group.

RESULTS

Dogs with sepsis had lower PON-1 activity compared with dogs in the LGSI group (1.1 ± 0.10 vs 1.6 ± 0.08 U/mL, P = .002), but no differences in BChE activity were detected between the groups. PON-1, ALB, and CRP could successfully discriminate healthy animals from those with sepsis looking at the area under the curve (AUC) of the receiver operator characteristics curves (ROCs), which were 0.828, 0.903 and 1.000, respectively. Finally, although no differences were found among the groups for PON-1 or BChE activity, the nonsurvivor septic dogs had higher CRP (P = .002), lower ALB (P = .025) levels, and tended to have lower PON-1 (P = .082) activities than the survivors at patient death or discharge.

CONCLUSION

Septic dogs showed lower plasma PON-1 and higher BChE activities, but only PON-1 activity correlated with disease severity. Further studies are warranted to describe the usefulness of these new biomarkers of sepsis progression and recovery in dogs.

摘要

背景

脓毒症是一种复杂的综合征,涉及氧化应激状态增加和胆碱能神经传递失调。对氧磷酶-1(PON-1)和丁酰胆碱酯酶(BChE)活性已被确定为监测人类脓毒症患者此类病症的重要生物标志物。

目的

我们旨在确定在脓毒症犬中,PON-1和BChE相对于其他传统急性期蛋白(如白蛋白(ALB)和C反应蛋白(CRP))的诊断和预后价值。

方法

这项前瞻性观察性研究纳入了20只诊断为脓毒症的犬、27只患有低度全身炎症(LGSI)的犬以及10只作为对照的健康犬。在所有犬入院时采集血浆样本进行分析,然后在脓毒症组中每24 - 48小时采集一次,直至出院或死亡。

结果

与LGSI组的犬相比,脓毒症犬的PON-1活性较低(1.1±0.10对1.6±0.08 U/mL,P = 0.002),但两组之间未检测到BChE活性的差异。从受试者操作特征曲线(ROC)的曲线下面积(AUC)来看,PON-1、ALB和CRP能够成功区分健康动物与脓毒症动物,其AUC分别为0.828、0.903和1.000。最后,尽管在PON-1或BChE活性方面各组之间未发现差异,但在患者死亡或出院时,非存活的脓毒症犬的CRP水平较高(P = 0.002),ALB水平较低(P = 0.025),且PON-1活性有低于存活犬的趋势(P = 0.082)。

结论

脓毒症犬血浆PON-1较低而BChE活性较高,但只有PON-1活性与疾病严重程度相关。有必要进一步研究以描述这些脓毒症进展和恢复的新生物标志物在犬中的有用性。

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