Sigrist Nadja E, Tritten Lucienne, Kümmerle-Fraune Claudia, Hofer-Inteeworn Natalie, Jud Schefer Rahel, Schnyder Manuela, Kutter Annette P N
Department for Small Animals, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Institute of Parasitology, University of Zurich, 8057 Zurich, Switzerland.
Pathogens. 2021 Aug 25;10(9):1077. doi: 10.3390/pathogens10091077.
infection has been associated with coagulopathies including hyperfibrinolysis. We compared coagulation status including thromboelastometry (ROTEM) parameters in dogs naturally infected with versus healthy dogs to determine clinicopathological parameters associated with bleeding, hypocoagulopathy, and hyperfibrinolysis. Clinical signs, white blood cell count, platelet count, hematocrit, plasmatic coagulation tests (PT, aPTT, fibrinogen concentration), D-dimer, and ROTEM S parameters (Ex-tem, In-tem, Fib-tem, Ap-tem) were analysed and compared between bleeding, nonbleeding, and control dogs and between hypo- and normocoagulable animals. Clinical signs of bleeding were present in 6/9 (67%) hypocoagulable and 1/9 (11%) normocoagulable dogs. PT, fibrinogen concentration, and several ROTEM parameters were significantly different between hypocoagulable and normocoagulabe infected dogs. Hyperfibrinolysis was identified in 44% of infected dogs and was significantly more common in bleeding and hypocoagulable dogs. Hyperfibrinolysis was significantly associated with low MCFFib-tem but not with low fibrinogen concentration or increased D-dimers. CFTEx-tem > 248 swas 100% sensitive and 89% specific to predict hyperfibrinolysis. Hyperfibrinolysis, hypocoagulability and bleeding are common in infected dogs. Only Ex-tem and Fib-tem parameters and potentially PT were associated with bleeding or hypocoagulability. Ex-tem analysis enables detection of bleeding, hypocoagulability and hyperfibrinolysis within minutes.
感染与包括高纤溶状态在内的凝血病有关。我们比较了自然感染犬与健康犬的凝血状态，包括血栓弹力图（ROTEM）参数，以确定与出血、低凝血症和高纤溶状态相关的临床病理参数。分析并比较了出血犬、非出血犬和对照犬之间以及低凝和正常凝血动物之间的临床症状、白细胞计数、血小板计数、血细胞比容、血浆凝血试验（PT、活化部分凝血活酶时间[aPTT]、纤维蛋白原浓度）、D-二聚体和ROTEM S参数（外源性凝血酶生成试验[Ex-tem]、内源性凝血酶生成试验[In-tem]、纤维蛋白原凝块形成试验[Fib-tem]、纤维蛋白溶解试验[Ap-tem]）。6/9（67%）的低凝犬和1/9（11%）的正常凝血犬出现了出血的临床症状。低凝和正常凝血的感染犬之间，PT、纤维蛋白原浓度和几个ROTEM参数有显著差异。44%的感染犬存在高纤溶状态，在出血和低凝犬中更为常见。高纤溶状态与低纤维蛋白原凝块形成试验中的最小凝血纤维蛋白凝块（MCFFib-tem）显著相关，但与低纤维蛋白原浓度或D-二聚体升高无关。外源性凝血酶生成试验中的凝血因子时间（CFTEx-tem）>248秒对预测高纤溶状态的敏感性为100%，特异性为89%。高纤溶状态、低凝血症和出血在感染犬中很常见。只有外源性凝血酶生成试验和纤维蛋白原凝块形成试验参数以及可能的PT与出血或低凝血症有关。外源性凝血酶生成试验分析能够在几分钟内检测出出血、低凝血症和高纤溶状态。
