Parra-Moyano Leonardo A, Cedeño Alejandro, Darby Shannon, Johnson Jessica P, Gomez Diego E
Department of Clinical Studies, University of Guelph, Ontario Veterinary College, Guelph, Ontario, Canada.
Clinica Equina, Vereda la Fagua, Cajicá, Cundinamarca, Colombia.
J Vet Intern Med. 2025 Jul-Aug;39(4):e70121. doi: 10.1111/jvim.70121.
The effectiveness of the peritoneal fluid L-lactate-to-total solids ratio (PFL:PFTS) as a diagnostic marker for strangulating lesions of the small intestine (SI) and large colon (LC) has not been investigated.
Describe and compare the PFL:PTFS and blood lactate (BL), peritoneal fluid lactate (PFL) and PFL:BL difference and PFL:BL ratio of horses with SI and LC strangulating (SO) and non-strangulating (NSO) obstructions and determine sensitivity and specificity to predict SO.
A total of 282 horses, 117 with SI lesions (59 classified as SINSO and 58 as SISO), and 165 with LC lesions, 126 categorized as LCNSO and 39 as LCSO.
Retrospective study. Receiver operating characteristic (ROC) curves were generated to identify optimal cut-off points to maximize sensitivity and specificity to predict SO.
A PFL:PFTS ratio of 2.9 had fair (area under the curve [AUC], 0.76; 95% confidence interval [CI], 0.67-0.84) ability to discriminate between SISO and SINSO, with sensitivity of 66.7% and specificity of 78.3% to predict SISO.
PFTS ratio of 3.6 had good ability to discriminate between LCSO and LCNSO (AUC, 0.84; 95% CI, 0.78-0.90) with sensitivity and specificity of 78% and 81% to predict LCSO, respectively. Peritoneal fluid lactate, PFL:BL difference, and PFL:BL ratio also had a low to moderate sensitivity to predict ischemic strangulating lesions of the SI and LC.
Strangulating obstructions are critical conditions requiring prompt intervention. The low to moderate sensitivity identified suggests that PFL, PFL:BL difference and ratio, and PFL:PFTS ratio should be interpreted with clinical signs and the response to initial treatment to determine SO accurately.
尚未研究腹腔液中L-乳酸与总固体比值（PFL:PFTS）作为小肠（SI）和大肠（LC）绞窄性病变诊断标志物的有效性。
描述并比较患有SI和LC绞窄性（SO）及非绞窄性（NSO）梗阻的马匹的PFL:PTFS、血乳酸（BL）、腹腔液乳酸（PFL）以及PFL:BL差值和PFL:BL比值，并确定预测SO的敏感性和特异性。
总共282匹马，117匹患有SI病变（59匹分类为SINSO，58匹为SISO），165匹患有LC病变，126匹分类为LCNSO，39匹为LCSO。
回顾性研究。生成受试者工作特征（ROC）曲线以确定最佳截断点，以最大化预测SO的敏感性和特异性。
PFL:PFTS比值为2.9时，区分SISO和SINSO的能力一般（曲线下面积[AUC]，0.76；95%置信区间[CI]，0.67 - 0.84），预测SISO的敏感性为66.7%，特异性为78.3%。
PFTS比值为3.6时，区分LCSO和LCNSO的能力良好（AUC，0.84；95%CI，0.78 - 0.90），预测LCSO的敏感性和特异性分别为78%和81%。腹腔液乳酸、PFL:BL差值和PFL:BL比值对预测SI和LC的缺血性绞窄性病变也具有低至中度的敏感性。
绞窄性梗阻是需要及时干预的危急情况。所确定的低至中度敏感性表明，应结合临床体征和对初始治疗的反应来解释PFL、PFL:BL差值和比值以及PFL:PFTS比值，以准确确定SO。
