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犬冷冻贫血浆纠正犬维生素 K 依赖性凝血功能障碍的体外研究。

An in vitro study of canine cryopoor plasma to correct vitamin K-dependent coagulopathy in dogs.

机构信息

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, Davis, CA, 95616, USA.

Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, 95616, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2021 Mar;31(2):231-238. doi: 10.1111/vec.13049. Epub 2021 Mar 22.

Abstract

OBJECTIVE

To compare the efficacy of fresh frozen plasma (FFP) with cryopoor plasma (CPP) to treat vitamin K-dependent factor deficiency in a canine in vitro setting.

DESIGN

In vitro laboratory study.

SETTING

University veterinary medical teaching hospital.

ANIMALS

Seven units of FFP and 6 units of CPP from unique canine donors from the university veterinary blood bank.

INTERVENTIONS

Canine FFP was adsorbed by oral barium sulfate suspension to mimic vitamin K-dependent coagulopathy. A sequential mixing study was completed by adding FPP or CPP to the adsorbed plasma. Measurements of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and factor activities of factors II, VII, and IX (FII, FVII, and FIX) were compared between the 2 treatment groups.

MEASUREMENTS AND MAIN RESULTS

When comparing the sequential addition of CPP or FPP to adsorbed plasma, the following had no statistical significance: PT (P = 0.94), aPTT (P = 0.66), FII (P = 0.05), and FIX (P = 0.90). There was a dose-dependent decrease with PT and aPTT and a dose-dependent increase with FII and FIX. In contrast, after the addition of either CPP or FFP, there was a significant difference between the treatment groups for the concentration of fibrinogen (P = 0.005) and activity of FVII (P = 0.044), with FFP resulting in a greater concentration of fibrinogen and CPP resulting in a greater concentration of FVII. Measurements of factor X (FX) were initially included in the study but were later excluded because FX appeared to be continually adsorbed even after the addition of CPP or FFP.

CONCLUSIONS

CPP partially corrected the coagulation times and concentration of vitamin K-dependent coagulation factors to the same degree as FFP. CPP, generally less expensive than FFP, may provide an alternative treatment option for vitamin K-dependent coagulopathies, although in vivo testing is needed.

摘要

目的

比较新鲜冷冻血浆(FFP)与贫浆冷冻血浆(CPP)在犬体外环境下治疗维生素 K 依赖性因子缺乏症的疗效。

设计

体外实验室研究。

地点

大学兽医教学医院。

动物

7 个单位的 FFP 和 6 个单位的 CPP,均来自大学兽医血库的独特犬供体。

干预措施

通过口服硫酸钡混悬液吸附犬 FFP,模拟维生素 K 依赖性凝血障碍。通过向吸附血浆中添加 FPP 或 CPP 完成顺序混合研究。比较 2 种治疗组之间的凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、纤维蛋白原和因子 II(FII)、因子 VII(FVII)和因子 IX(FIX)的活性。

测量和主要结果

当比较 CPP 或 FPP 顺序添加到吸附血浆时,以下指标无统计学意义:PT(P=0.94)、aPTT(P=0.66)、FII(P=0.05)和 FIX(P=0.90)。PT 和 aPTT 随剂量降低而降低,FII 和 FIX 随剂量增加而增加。相比之下,添加 CPP 或 FFP 后,纤维蛋白原浓度(P=0.005)和 FVII 活性(P=0.044)在治疗组之间有显著差异,FFP 导致纤维蛋白原浓度增加,CPP 导致 FVII 浓度增加。因子 X(FX)的测量最初包括在研究中,但后来被排除,因为 CPP 或 FFP 加入后,FX 似乎仍在不断被吸附。

结论

CPP 部分纠正了凝血时间和维生素 K 依赖性凝血因子的浓度,与 FFP 达到相同程度。CPP 通常比 FFP 便宜,可能为维生素 K 依赖性凝血障碍提供替代治疗选择,尽管需要进行体内测试。

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