College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.
J Vet Intern Med. 2022 Sep;36(5):1820-1826. doi: 10.1111/jvim.16522. Epub 2022 Aug 23.
Hyponatremia is common in horses with bacterial pleuropneumonia, but no further characterization of this abnormality has been reported.
Describe admission plasma sodium concentration ([Na]) in horses with septic pneumopathy and evaluate any association of plasma [Na] with markers of systemic inflammation.
Medical records of horses >1 month of age that between 2008 and 2021 had a transtracheal aspirate (TTA) performed, abnormal TTA cytology, positive TTA culture, pulmonary disease on ultrasonography, radiography or both, and plasma [Na] assessed by direct ion-selective-electrode (dISE). Horses with concurrent diarrhea or azotemia were excluded.
Clinical and clinicopathological variables of interest between hypo- and normonatremic horses were compared. Spearman correlation and Fisher exact tests were used to identify significant associations (P < .05).
Twenty of 35 horses had hyponatremia (median, 132 mmol/L; 25-75th interquartile range [IQR], 129.7-133.1 mmol/L; reference range, 134.2-138.4 mmol/L). A higher proportion of horses with systemic inflammatory response syndrome (SIRS) had hyponatremia (P = .01). Hyponatremic patients had higher mean plasma fibrinogen concentration (461 ± 160.5 mg/dL; P = .01) and higher rectal temperature (38.8 ± 0.7°C; P = .02) than normonatremic horses. Negative correlations were found between plasma [Na] and fibrinogen (P = .001; ρ = -0.57) concentrations and between plasma [Na] and rectal temperature (P = .001; ρ = -0.51). Presence or absence of pleural effusion did not influence severity of hyponatremia. Mean duration of hospitalization was longer (P = .04) in hyponatremic horses (9.8 ± 6.6 days).
Hyponatremia at admission is associated with the presence of inflammation, SIRS, and with longer duration of hospitalization.
低钠血症在患有细菌性胸膜肺炎的马中很常见，但尚未对这种异常进行进一步描述。
描述患有败血性肺炎的马入院时的血浆钠浓度([Na])，并评估血浆[Na]与全身炎症标志物之间的任何关联。
2008 年至 2021 年间进行了经气管抽吸术（TTA）、TTA 细胞学异常、TTA 培养阳性、超声、放射学或两者均有肺部疾病，且通过直接离子选择性电极（dISE）评估血浆[Na]的>1 月龄马。排除同时患有腹泻或氮质血症的马。
比较低钠血症和正常钠血症马的临床和临床病理变量。使用 Spearman 相关和 Fisher 确切检验来确定显著关联（P<.05）。
35 匹马中有 20 匹患有低钠血症（中位数 132mmol/L；25-75 百分位区间[IQR] 129.7-133.1mmol/L；参考范围 134.2-138.4mmol/L）。患有全身性炎症反应综合征（SIRS）的马中，低钠血症的比例更高（P=.01）。低钠血症患者的平均血浆纤维蛋白原浓度（461±160.5mg/dL；P=.01）和直肠温度（38.8±0.7°C；P=.02）更高。血浆[Na]与纤维蛋白原（P=.001；ρ=-0.57）浓度和与直肠温度（P=.001；ρ=-0.51）呈负相关。胸腔积液的存在与否并不影响低钠血症的严重程度。低钠血症马的住院时间更长（P=.04；9.8±6.6 天）。
入院时的低钠血症与炎症、SIRS 的存在以及住院时间的延长有关。
