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犬脓毒症中血清载脂蛋白A1的评估

Evaluation of Serum Apolipoprotein A1 in Canine Sepsis.

作者信息

Giunti Massimo, Grossi Giorgio, Troía Roberta, Fracassi Federico, Dondi Francesco

机构信息

Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.

出版信息

Front Vet Sci. 2020 May 13;7:263. doi: 10.3389/fvets.2020.00263. eCollection 2020.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95dd/7238865/07e39f457b88/fvets-07-00263-g0001.jpg

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