Relação entra as concentrações plasmáticas e peritoneais de dímeros-D e as variáveis clínicas e laboratoriais de equinos com síndrome cólica
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Data
2017-09-26
Autores
Crescencio, Amanda Paulino
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Universidade Estadual Paulista (Unesp)
Resumo
Nos equinos, os distúrbios gastrointestinais (GI) são as causas mais comuns de problemas de coagulação, podendo gerar complicações fatais. Atualmente, uma das ferramentas mais sensíveis para avaliação da hipercoagulabilidade e hiperfibrinólise em cavalos é a determinação das concentrações de dímeros-D. Dessa forma, objetivou-se relacionar as concentrações plasmáticas e peritoneais de dímeros-D com as variáveis clínicas (frequência cardíaca, frequência respiratória, cor das membranas mucosas, tempo de preenchimento capilar, temperatura retal, grau de dor e tempo de evolução do quadro) e laboratoriais (hematócrito, proteína plasmática total, plaquetas, fibrinogênio e leucócitos sanguíneos, além de proteína, fibrinogênio, células nucleadas, bactérias e glicose no líquido peritoneal) de equinos com síndrome cólica e com o diagnóstico e prognóstico desses casos. Foram utilizados 86 equinos com idade mediana de 6,5 anos e com peso mediano de 400 Kg. Os animais foram submetidos ao exame clínico e coleta de amostras de sangue e líquido peritoneal (LP) na admissão. As concentrações plasmáticas e peritoneais de dímeros-D foram avaliadas através de um ensaio semiquantitativo de aglutinação em látex. Apesar das concentrações plasmáticas e peritoneais de dímeros-D terem demonstrado um sentido biológico relacionado à gravidade dos casos de cólica na análise descritiva, isso não foi comprovado estatisticamente através da análise multivariada. Portanto, concluímos que a determinação das concentrações plasmáticas e peritoneais de dímeros-D através da utilização de kits semiquantitativos de aglutinação em látex não teve sensibilidade para predição da gravidade e elucidação do diagnóstico e prognóstico de equinos com síndrome cólica, devendo ter seus resultados cuidadosamente interpretados pelo médico veterinário na rotina clínica. Mais estudos são necessários para avaliar a utilidade da determinação das concentrações plasmáticas e peritoneais de dímeros-D através de outros métodos laboratoriais.
In horses, gastrointestinal (GI) disorders are the most common cause of coagulation problems, which can lead to fatal complications. One of the most sensitive tools for assessing hypercoagulability and hyperfibrinolysis in horses is the determination of D-dimer concentrations. The aim of this study was to correlate the plasma and peritoneal D-dimer concentrations with the clinical variables (heart rate, respiratory rate, mucous membranes color, capillary filling time, rectal temperature, pain degree, and time frame evolution) (hematocrit, total plasma protein, platelets, fibrinogen and blood leukocytes, as well as protein, fibrinogen, nucleated cells, bacteria and glucose in the peritoneal fluid) of horses with colic syndrome and with the diagnosis and prognosis of these cases. A total of 86 horses with a median age of 6.5 years and with a median weight of 400 kg were used. The animals were submitted to clinical examination and collection of blood and peritoneal fluid (LP) samples at admission. Plasma and peritoneal concentrations of D-dimers were evaluated by a semi-quantitative latex agglutination assay. Although plasma and peritoneal concentrations of D-dimers demonstrated a biological significance related to the severity of colic cases in the descriptive analysis, this was not statistically demonstrated through multivariate analysis. Therefore, we concluded that the determination of plasma and peritoneal concentrations of D-dimers using semi-quantitative latex agglutination kits was not sensitive to prediction of severity and elucidation of the diagnosis and prognosis of horses with colic syndrome, and their results should be carefully interpreted by the veterinarian in the clinical routine. More studies are needed to evaluate the usefulness of determining plasma and peritoneal concentrations of D-dimers through other laboratory methods.
In horses, gastrointestinal (GI) disorders are the most common cause of coagulation problems, which can lead to fatal complications. One of the most sensitive tools for assessing hypercoagulability and hyperfibrinolysis in horses is the determination of D-dimer concentrations. The aim of this study was to correlate the plasma and peritoneal D-dimer concentrations with the clinical variables (heart rate, respiratory rate, mucous membranes color, capillary filling time, rectal temperature, pain degree, and time frame evolution) (hematocrit, total plasma protein, platelets, fibrinogen and blood leukocytes, as well as protein, fibrinogen, nucleated cells, bacteria and glucose in the peritoneal fluid) of horses with colic syndrome and with the diagnosis and prognosis of these cases. A total of 86 horses with a median age of 6.5 years and with a median weight of 400 kg were used. The animals were submitted to clinical examination and collection of blood and peritoneal fluid (LP) samples at admission. Plasma and peritoneal concentrations of D-dimers were evaluated by a semi-quantitative latex agglutination assay. Although plasma and peritoneal concentrations of D-dimers demonstrated a biological significance related to the severity of colic cases in the descriptive analysis, this was not statistically demonstrated through multivariate analysis. Therefore, we concluded that the determination of plasma and peritoneal concentrations of D-dimers using semi-quantitative latex agglutination kits was not sensitive to prediction of severity and elucidation of the diagnosis and prognosis of horses with colic syndrome, and their results should be carefully interpreted by the veterinarian in the clinical routine. More studies are needed to evaluate the usefulness of determining plasma and peritoneal concentrations of D-dimers through other laboratory methods.
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Palavras-chave
diagnóstico, fibrinólise, hipercoagulabilidade, prognóstico