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临床健康非洲象即时护理粘弹性凝血监测仪的研究及其与血栓弹力图的比较()。

INVESTIGATION OF A POINT-OF-CARE VISCOELASTIC COAGULATION MONITOR AND ITS COMPARISON TO THROMBOELASTOGRAPHY IN CLINICALLY HEALTHY AFRICAN ELEPHANTS ().

作者信息

Heniff Ashlyn C, Lynch Alex M, Ruterbories Laura K, Minter Larry J, Georoff Timothy A, Balko Julie A

机构信息

College of Veterinary Medicine, Departments of Clinical Sciences, North Carolina State University, Raleigh, NC 27606, USA.

North Carolina Zoo, Asheboro, NC 27205, USA.

出版信息

J Zoo Wildl Med. 2024 Mar;55(1):164-172. doi: 10.1638/2022-0158.

Abstract

Elephant endotheliotropic herpesvirus (EEHV) can induce fatal hemorrhagic disease (HD) in African elephants (). Once clinical signs develop, progression is rapid, even with aggressive treatment. There is a critical need to develop point-of-care diagnostic tests to aid in identification of EEHV-HD prior to the onset of overt clinical signs. Study objectives were to investigate a novel, point-of-care viscoelastic coagulation monitor (VCM Vet), compare the results to thromboelastography (TEG), and report traditional hemostatic analytes in adult African elephants. Whole blood was collected from seven clinically healthy elephants (four females and three males, 18-47 yr) and analyzed in duplicate via VCM Vet and kaolin-activated TEG 1-3 and 30 min following collection, respectively. Separated plasma was frozen for ancillary coagulation testing. Both analyses generated quantifiable clotting reactions with variables (median [range]) describing clot formation rate (VCM Vet, clot time = 682 s [530-987 s], clot formation time = 244 s [186-744 s], Alpha = 40° [14-47°]; TEG, reaction time = 6.2 min [3.7-11.8 min], kinetic time = 1.3 min [0.9-2.6 min], Alpha = 70° [57-77°]), clot strength (VCM Vet, maximum clot formation = 34 units [20-45 units]; TEG, maximum amplitude = 75 mm [69-80 mm], shear elastic modulus strength = 14.7 Kdynes/s [11.3-19.5 Kdynes/s]), and clot lysis (VCM Vet, lysis index at 30 min = 100% [100-99%], lysis index at 45 min = 98% [95-100%]; TEG, lysis index at 30 min = 0% [0-0.4%], lysis index at 60 min = 1.4% [0-2.6%]) recorded. Additional testing (median [range]) included D-dimer concentration (33 ng/ml [28-94 ng/ml]), prothrombin time (12.4 s [12.2-13.2 s]), activated partial thromboplastin time (17.2 s [14.2-18.8 s]), and fibrinogen concentration (297 [282-383] mg/dL). Tracings generated by VCM Vet and TEG were clinically similar, and there was visual agreement and minimal difference between quantitative variables for duplicate tests. VCM Vet is a promising, user-friendly tool for use in identification and management of coagulopathies in African elephants.

摘要

大象内皮嗜性疱疹病毒(EEHV)可在非洲象中引发致命的出血性疾病(HD)。一旦出现临床症状,病情进展迅速,即便积极治疗也无济于事。迫切需要开发即时诊断测试,以在明显临床症状出现之前协助识别EEHV-HD。研究目的是调查一种新型的即时粘弹性凝血监测仪(VCM Vet),将结果与血栓弹力图(TEG)进行比较,并报告成年非洲象的传统止血分析物。从7头临床健康的大象(4头雌性和3头雄性,18 - 47岁)采集全血,分别在采集后1 - 3分钟和30分钟通过VCM Vet和高岭土激活的TEG进行重复分析。分离的血浆冷冻用于辅助凝血测试。两种分析均产生了可量化的凝血反应,记录了描述凝血形成速率(VCM Vet,凝血时间 = 682秒[530 - 987秒],凝血形成时间 = 244秒[186 - 744秒],α = 40°[14 - 47°];TEG,反应时间 = 6.2分钟[3.7 - 11.8分钟],动力学时间 = 1.3分钟[0.9 - 2.6分钟],α = 70°[57 - 77°])、凝血强度(VCM Vet,最大凝血形成 = 34单位[20 - 45单位];TEG,最大振幅 = 75毫米[69 - 80毫米],剪切弹性模量强度 = 14.7千达因/秒[11.3 - 19.5千达因/秒])和凝块溶解(VCM Vet,30分钟时溶解指数 = 100%[100 - 99%],45分钟时溶解指数 = 98%[95 - 100%];TEG,30分钟时溶解指数 = 0%[0 - 0.4%],60分钟时溶解指数 = 1.4%[0 - 2.6%])的变量(中位数[范围])。额外测试(中位数[范围])包括D - 二聚体浓度(33纳克/毫升[28 - 94纳克/毫升])、凝血酶原时间(12.4秒[12.2 - 13.2秒])、活化部分凝血活酶时间(17.2秒[14.2 - 18.8秒])和纤维蛋白原浓度(297[282 - 383]毫克/分升)。VCM Vet和TEG生成的图形在临床上相似,重复测试的定量变量之间在视觉上一致且差异极小。VCM Vet是一种有前景的、用户友好的工具,可用于识别和管理非洲象的凝血病。

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