Lee Jong-Sun, Kim Jung-Hyun
Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.
Animals (Basel). 2022 Jan 18;12(3):226. doi: 10.3390/ani12030226.
Snake envenomation may lead to venom-induced consumptive coagulopathy (VICC), usually diagnosed by classical coagulation tests (CCTs), such as prothrombin time (PT) and activated partial thromboplastin time (aPTT). However, the results of CCTs are frequently normal in the initial stages, which may delay anti-venom treatments. Thromboelastography (TEG) is a point-of-care and real-time diagnostic tool that enables a comprehensive assessment of the coagulation process. This in vitro study aimed to determine concentration-dependent changes in canine blood caused by () envenomation using TEG and CCTs. Lyophilized venom was reconstructed using mouse intravenous lethal dose 50 (LD50) and serially diluted to 25% LD50, 50% LD50, and 75% LD50 to reproduce VICC at different concentrations. Normal saline was used for the control. We compared TEG values of the reaction time (R), kinetic time (K), rate of clot formation (α-angle), maximum amplitude (MA), fibrinolysis at 30 min (LY30), and global strength of the clot (G) with those of PT, aPTT, fibrinogen, and platelet counts (PLTs). Most TEG parameters, except R and LY30, demonstrated statistically significant changes compared with the control at all concentrations. CCTs, except PLTs, revealed significant changes at ≥50% LD50. Thus, TEG could be a useful diagnostic strategy for early VICC and preventing treatment delay.
蛇咬伤中毒可能导致毒液诱导的消耗性凝血病（VICC），通常通过经典凝血试验（CCTs）进行诊断，如凝血酶原时间（PT）和活化部分凝血活酶时间（aPTT）。然而，CCTs的结果在初始阶段通常是正常的，这可能会延迟抗蛇毒血清治疗。血栓弹力图（TEG）是一种即时床旁实时诊断工具，能够全面评估凝血过程。这项体外研究旨在使用TEG和CCTs确定由（）毒液中毒引起的犬类血液中浓度依赖性变化。使用小鼠静脉注射半数致死剂量（LD50）对冻干毒液进行重构，并将其依次稀释至25%LD50、50%LD50和75%LD50，以再现不同浓度下的VICC。使用生理盐水作为对照。我们将反应时间（R）、动力学时间（K）、凝血形成速率（α角）、最大振幅（MA）、30分钟时的纤维蛋白溶解（LY30）以及血凝块的整体强度（G）的TEG值与PT、aPTT、纤维蛋白原和血小板计数（PLTs）进行了比较。与对照组相比，除R和LY30外，大多数TEG参数在所有浓度下均表现出统计学上的显著变化。除PLTs外，CCTs在≥50%LD50时显示出显著变化。因此，TEG可能是早期诊断VICC和防止治疗延迟的一种有用诊断策略。
