电解质异常和未测定阴离子在犬细小病毒性肠炎代谢性酸碱平衡紊乱中的作用。

Role of electrolyte abnormalities and unmeasured anions in the metabolic acid-base abnormalities in dogs with parvoviral enteritis.

机构信息

Veterinary and Biomedical Sciences, James Cook University, Townsville, Queensland, Australia.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.

出版信息

J Vet Intern Med. 2020 Mar;34(2):857-866. doi: 10.1111/jvim.15749. Epub 2020 Mar 4.

DOI:10.1111/jvim.15749

PMID:32133703

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7096617/

Abstract

BACKGROUND

The strong ion model (SIM) is an alternative paradigm in the characterization of acid-base disturbances particularly in complex disorders.

HYPOTHESIS/OBJECTIVES: To compare the acid-base changes in dogs with parvoviral enteritis (PE) using the Henderson-Hasselbalch (HH) approach, with 2 strong ion approaches.

ANIMALS

Forty-four dogs with PE, and 16 age-matched control dogs.

METHODS

Prospective controlled observational study. Acid-base status was evaluated using the HH model, Fencl-Stewart (FS) approach and a validated strong ion model (VDM). The acid-base changes according to each model were classified and compared. Statistical correlations between pH, CO , and various SIM variables were performed, as well as between the sum of effects (SOE) of the SIM and the individual variables comprising the SOE.

RESULTS

The HH model identified acid-base disorders in 31/44 cases of which 16/31 were mixed with metabolic acidosis and concurrent respiratory alkalosis the most common (10/31). Using the FS approach, metabolic changes were present 36/42 cases, with changes in free water (FW), chloride, and unmeasured anions (UA) being the most prevalent. Both FW and UA correlated well with pH; however, UA were most consistently abnormal in severe acidemia. Similarly to the HH, the VDM detected acid-base disturbances in 28/44 cases. Major contributors to the acid-base changes were hyponatremia, hypochloremia, and A acidosis because of elevated globulins and increased UA.

CONCLUSIONS AND CLINICAL IMPORTANCE

Acid-base changes are common and complex in dogs with PE, and were easier to understand using a SIM paradigm. Increases in UA have not been documented in PE in dogs.

摘要

背景

强离子模型（SIM）是一种描述酸碱紊乱的替代范式，尤其适用于复杂疾病。

假设/目的：使用 Henderson-Hasselbalch（HH）方法和 2 种强离子方法比较犬细小病毒性肠炎（PE）的酸碱变化。

动物

44 只患有 PE 的犬和 16 只年龄匹配的对照犬。

方法

前瞻性对照观察研究。使用 HH 模型、Fencl-Stewart（FS）方法和经过验证的强离子模型（VDM）评估酸碱状态。根据每种模型对酸碱变化进行分类和比较。对 pH、CO2 和各种 SIM 变量之间的统计相关性进行了研究，以及 SIM 的总和效应（SOE）与构成 SOE 的各个变量之间的相关性。

结果

HH 模型在 31/44 例犬中识别出酸碱紊乱，其中 16/31 例为代谢性酸中毒和同时存在的呼吸性碱中毒最常见（10/31）。使用 FS 方法，36/42 例存在代谢变化，其中自由水（FW）、氯和未测阴离子（UA）的变化最为常见。FW 和 UA 与 pH 相关性良好，但在严重酸中毒时 UA 最常异常。与 HH 类似，VDM 在 28/44 例犬中检测到酸碱紊乱。导致酸碱变化的主要因素是低钠血症、低氯血症和 A 酸中毒，这是由于球蛋白升高和 UA 增加所致。