Giunti Massimo, Grossi Giorgio, Troía Roberta, Fracassi Federico, Dondi Francesco
Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Front Vet Sci. 2020 May 13;7:263. doi: 10.3389/fvets.2020.00263. eCollection 2020.
Decreased serum apolipoprotein A1 (Apo-A1) concentration is associated with mortality in human sepsis. The diagnostic and prognostic role of serum Apo-A1 concentrations in canine sepsis was evaluated. Serum samples from septic dogs ( = 91) and healthy controls ( = 15) were retrospectively analyzed. According to the sepsis origin, four categories were identified: parvoviral enteritis ( = 26), pyometra ( = 20), septic peritonitis ( = 19), and miscellanea ( = 26). The canine acute patient physiologic and laboratory evaluation fast score (APPLE), serum C-reactive protein (CRP) and albumin concentrations were reviewed in all enrolled dogs. Increased CRP (252.6 ± 119.2 mg/L; Reference Interval: 0-8.5 mg/L) and significant lower serum albumin and Apo-A1 concentrations were documented in dogs with sepsis (22.8 ± 5.3 g/L and 1.17 ± 0.27 g/L, respectively) compared to healthy ones (33.1 ± 2.5 g/L and 1.32 ± 0.05 g/L, respectively) ( < 0.0001). According to the origin of sepsis, only the subgroup of dogs with septic peritonitis had significantly lower Apo-A1 (1.03 ± 0.26 g/L) concentrations compared to healthy dogs ( < 0.001). No significant differences were found in serum albumin and CRP concentrations, and in APPLE score values among the different subgroups of sepsis. Diagnosis of septic peritonitis was associated with a higher frequency of death ( = 0.006). In septic dogs, significant lower Apo-A1 concentrations were detected in non-survivors (1.02 ± 0.28 g/L; = 27) compared to survivors (1.23 ± 0.24 g/L; = 64; = 0.0007). Moreover, significant higher values of the APPLE score were calculated in non-survivors (26 ± 4; = 19) compared to survivors (23 ± 4; = 51) ( = 0.0114). According to the area under the ROC curve analysis, Apo-A1 <96 mg/dl had a fair accuracy (AUC = 0.72) to correctly predict mortality ( = 0.0004). Apo-A1 might support a diagnosis of canine septic peritonitis with a potential prognostic significance. Further prospective studies are warranted.
血清载脂蛋白A1（Apo - A1）浓度降低与人类脓毒症的死亡率相关。本研究评估了血清Apo - A1浓度在犬类脓毒症中的诊断和预后作用。回顾性分析了脓毒症犬（n = 91）和健康对照犬（n = 15）的血清样本。根据脓毒症的起源，分为四类：细小病毒性肠炎（n = 26）、子宫蓄脓（n = 20）、化脓性腹膜炎（n = 19）和其他（n = 26）。对所有纳入研究的犬只评估犬急性病人生理和实验室快速评估评分（APPLE）、血清C反应蛋白（CRP）和白蛋白浓度。与健康犬（分别为33.1±2.5 g/L和1.32±0.05 g/L）相比，脓毒症犬的CRP升高（252.6±119.2 mg/L；参考区间：0 - 8.5 mg/L），血清白蛋白和Apo - A1浓度显著降低（分别为22.8±5.3 g/L和1.17±0.27 g/L）（P < 0.0001）。根据脓毒症的起源，只有化脓性腹膜炎犬亚组的Apo - A1浓度（1.03±0.26 g/L）显著低于健康犬（P < 0.001）。不同脓毒症亚组之间的血清白蛋白、CRP浓度及APPLE评分值无显著差异。化脓性腹膜炎的诊断与较高的死亡频率相关（P = 0.006）。在脓毒症犬中，非存活者（1.02±0.28 g/L；n = 27）的Apo - A1浓度显著低于存活者（1.23±0.24 g/L；n = 64；P = 0.0007）。此外，非存活者（26±4；n = 19）的APPLE评分显著高于存活者（23±4；n = 51）（P = 0.0114）。根据ROC曲线下面积分析，Apo - A1 < 96 mg/dl对正确预测死亡率具有较好的准确性（AUC = 0.72）（P = 0.0004）。Apo - A1可能有助于犬化脓性腹膜炎的诊断，并具有潜在预后意义。有必要进行进一步的前瞻性研究。
