Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California, USA.
Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, St. Kitts & Nevis.
J Vet Intern Med. 2022 Mar;36(2):464-472. doi: 10.1111/jvim.16369. Epub 2022 Feb 15.
Current diagnostic evaluation of transudative effusions rarely aids in identifying an underlying etiology. Lipoproteins in the fluid might reflect the site or nature of vessel involvement.
Improve the classification and diagnostic utility of pleural and peritoneal transudates in dogs and cats by investigating lipoprotein patterns in effusions. Compare these patterns with other peritonaeal and pleural fluid variables and underlying diseases.
Samples of transudates and serum from 18 cats and 37 dogs with transudative effusion (total nucleated cell count [TNCC] <5000 cells/μL) were analyzed.
Lipoprotein fractions, triglyceride, and cholesterol (CHO) concentrations were prospectively determined in paired fluid and serum samples. Standard fluid measurements were retrospectively collected.
Two distinct fluid lipoprotein patterns were noted. Fluids rich in VLDL+IDL were associated with chronic kidney disease, acquired portosystemic shunts or protein-losing enteropathy (group I). Fluids rich in denser lipoproteins were associated with underlying heart disease, caudal vena cava syndrome or intracavitary neoplasia (group II). Group I and group II also had significant differences between fluid concentrations of CHO (x̄ = 8 vs 110 mg/dL) and TP (x̄ = 0.6 vs 3.8 g/dL), respectively. Five peritoneal transudates were triglyceride-rich (>100 mg/dL) and associated with pancreatitis.
Protein-poor (TP <1.5 g/dL) and protein-rich (TP >2.5 g/dL) transudates were associated with distinct lipoprotein patterns and specific groups of disease. Effusions secondary to pancreatitis might be transudative and rich in triglycerides.
目前对渗出液的诊断评估很少有助于确定潜在病因。液体中的脂蛋白可能反映了血管受累的部位或性质。
通过研究胸腔和腹腔渗出液中的脂蛋白模式,改善犬猫胸腔和腹腔渗出液的分类和诊断效用。将这些模式与其他腹腔和胸腔液变量以及潜在疾病进行比较。
分析了 18 只猫和 37 只患有渗出性积液(总核细胞计数 [TNCC] <5000 个/μL)的犬的渗出液和血清样本。
前瞻性地确定配对的液体和血清样本中的脂蛋白馏分、甘油三酯和胆固醇(CHO)浓度。回顾性地收集标准液体测量值。
注意到两种不同的液体脂蛋白模式。富含 VLDL+IDL 的液体与慢性肾病、获得性门体分流或蛋白丢失性肠病(I 组)相关。富含密度较高的脂蛋白的液体与潜在的心脏病、腔静脉后综合征或腔内肿瘤(II 组)相关。I 组和 II 组之间的 CHO(x̄=8 与 110mg/dL)和 TP(x̄=0.6 与 3.8g/dL)的液体浓度也有显著差异。5 例腹腔渗出液富含甘油三酯(>100mg/dL),与胰腺炎有关。
低蛋白(TP <1.5g/dL)和高蛋白(TP >2.5g/dL)渗出液与不同的脂蛋白模式和特定的疾病组相关。继发于胰腺炎的渗出液可能是透性的,富含甘油三酯。