Meyer T S, Fedde M R, Gaughan E M, Langsetmo I, Erickson H H
Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan 66506-5602, USA.
Equine Vet J. 1998 Jul;30(4):284-8. doi: 10.1111/j.2042-3306.1998.tb04098.x.
Exercise-induced pulmonary haemorrhage (EIPH) causes serious economic losses in the horse racing industry. Endoscopic examination indicates that 40-90% of horses exhibit EIPH following sprint exercise, but the limitations of the endoscope prevent diagnosis in many horses. Bronchoalveolar lavage (BAL) was utilised to detect red blood cells (RBCs) in the terminal airways in 6 horses. Two lavages were performed at weekly intervals prior to exercise, one within 90 min after exercise, and 5 at weekly intervals after exercise. The horses were exercised strenuously at 12.5-14.6 m/s on a treadmill (3 degree incline). Heart rates ranged from 192-207 beats/min, and mean pulmonary arterial pressures (mPAP) ranged from 80-102 mmHg. Neither epistaxis nor endoscopic evidence of EIPH was seen in any of the 6 horses following exercise. However, the number of RBCs in the lavage fluid increased significantly over control values immediately after exercise in all horses but returned to control values by one week after exercise. Haemosiderophages in the BAL fluid did not increase until one week after exercise and remained elevated for 3 weeks after exercise. Twenty per cent of the total population of alveolar macrophages contained haemosiderin. A positive relationship occurred between the number of RBCs in the lavage fluid and mPAP; the amount of haemorrhage increased as the mPAP exceeded 80 to 90 mmHg. The results with BAL used as the diagnostic tool, suggest that all strenuously exercised horses may exhibit EIPH; the amount of haemorrhage appears to be associated with the magnitude of the high pulmonary arterial pressure.
运动性肺出血（EIPH）给赛马行业造成了严重的经济损失。内镜检查表明，40%至90%的马匹在短跑运动后会出现EIPH，但内镜的局限性使得许多马匹无法得到诊断。对6匹马进行支气管肺泡灌洗（BAL）以检测终末气道中的红细胞（RBC）。在运动前每隔一周进行两次灌洗，运动后90分钟内进行一次灌洗，运动后每隔一周进行5次灌洗。这些马在跑步机（3度倾斜）上以12.5至14.6米/秒的速度剧烈运动。心率范围为192至207次/分钟，平均肺动脉压（mPAP）范围为80至102毫米汞柱。运动后，6匹马中均未出现鼻出血或EIPH的内镜证据。然而，所有马匹运动后立即灌洗 fluid中的红细胞数量均显著高于对照值，但在运动后一周恢复到对照值。BAL fluid中的含铁血黄素巨噬细胞直到运动后一周才增加，并在运动后持续升高3周。肺泡巨噬细胞总数的20%含有含铁血黄素。灌洗 fluid中的红细胞数量与mPAP之间存在正相关关系；随着mPAP超过80至90毫米汞柱，出血量增加。以BAL作为诊断工具的结果表明，所有剧烈运动的马匹可能都会出现EIPH；出血量似乎与高肺动脉压的程度有关。
