Thromboelastography in Dogs with Chronic Hepatopathies.
Thromboelastography in Dogs with Chronic Hepatopathies.
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DOI：
10.1111/jvim.14639
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发表时间：
2017-03
影响因子：
2.6
通讯作者：
Webster CR
中科院分区：
文献类型：
--
作者：
Fry W;Lester C;Etedali NM;Shaw S;DeLaforcade A;Webster CR
用常规凝血试验很难预测肝病犬的凝血状态。目的评价犬慢性肝病(CH)的血栓弹性成像(TEG)结果及其与常规凝血结果、病情严重程度和预后指标的关系。21只客户拥有的狗。从2008年到2014年，前瞻性地(10只狗)和回溯性地(11只狗)纳入患有CH的犬。进行高岭土活化的TEG，并通过t检验或Mann-Whitney检验与参考间隔进行比较。确定TEG结果与常规凝血和临床病理结果的相关系数。意义被设定在P<；0.05。充血性心力衰竭犬的R(5.30min比4.33min)、K(3.77min比2.11min)、LY30(4.77%比0.68%)和角度减小(55.3°比62.4°)显著增加。G值将21只狗中的9只定义为正常凝血，7只定义为高凝，5只定义为低凝。G、MA与纤维蛋白原(r=0.6 8，0.83)、凝血酶原时间(PT；r=−0.5 1，−0.5 3)、活化部分凝血活酶时间(aPTT；r=−0.5 0，−0.5 0)相关。K与PT(r=0.75)、蛋白C活性(r=−0.92)呈正相关。角度与a PTT呈正相关(r=−0.6 3)。临床评分与PT(r=0.6 0)、MA(r=−0.5 3)、R(r=−0.4 7)相关。纤溶亢进的狗(LY30和GT；3.04%；21只狗中有5只)血清转氨酶活性显著升高。门脉高压犬的G、MA、ANGE显著降低，K、R、PT显著延长。患有CH的狗有不同的TEG结果。脑出血的阴性预后指标与TEG的低凝参数相关。慢性肝炎犬的纤溶功能亢进与疾病活动性高有关。
The coagulation status of dogs with liver disease is difficult to predict using conventional coagulation testing. To evaluate thromboelastography (TEG) results and associations with conventional coagulation results and indicators of disease severity and prognosis in dogs with chronic hepatopathies (CH). Twenty‐one client‐owned dogs. Dogs with CH were prospectively (10 dogs) and retrospectively (11 dogs) enrolled from 2008 to 2014. Kaolin‐activated TEG was performed and compared with reference intervals by t‐tests or Mann‐Whitney tests. Correlation coefficients for TEG results and conventional coagulation and clinicopathologic results were determined. Significance was set at P < .05. Dogs with CH had significant increases in R (5.30 min vs 4.33 min), K (3.77 min vs 2.11 min), and LY30 (4.77% vs 0.68%) and decreased angles (55.3° vs 62.4°). G value defined 9 of 21, 7 of 21, and 5 of 21 dogs as normocoagulable, hypercoagulable, and hypocoagulable, respectively. G and MA were correlated with fibrinogen (r = 0.68, 0.83), prothrombin time (PT; r = −0.51, −0.53), and activated partial thromboplastin time (aPTT; r = −0.50, −0.50). K was correlated with PT (r = 0.75) and protein C activity (r = −0.92). Angle was correlated with aPTT (r = −0.63). Clinical score was correlated with PT (r = 0.60), MA (r = −0.53), and R (r = −0.47). Dogs with hyperfibrinolysis (LY30 > 3.04%; 5 of 21) had significantly higher serum transaminase activities. Dogs with portal hypertension had significantly lower G, MA, and angle and prolonged, K, R, and PT. Dogs with CH have variable TEG results. Negative prognostic indicators in CH correlate with hypocoagulable parameters on TEG. Hyperfibrinolysis in dogs with CH is associated with high disease activity.