背景:心力衰竭相关的低氯血症可能是利尿剂所致的,也可能是水潴留所致的稀释。血清渗透压反映了水平衡,但尚未在患有心脏病的狗中进行评估。
目的:确定血清渗透压是否与健康犬和粘液瘤二尖瓣变性(MMVD)犬的心脏病分期和血清氯(Cl-)浓度的数学校正量有关。
方法:77只狗(20只健康,25阶段BMMVD,32阶段C/DMMVD)。
方法:对血清Cl-浓度进行数学校正。计算渗透压(calOsm)并通过冰点降低(dmOsm)直接测量,并通过Bland-Altman分析进行比较。生化变量和渗透压在健康人群中进行了比较,B阶段,和C/D阶段的狗。研究了渗透压与生化变量之间的相关性。给出了中位数和范围。P<0.05被认为是显著的。
结果:组间比较差异(P=0.003),阶段B(310mOsm/kg;306、316)和C/D狗(312mOsm/kg;308、319)的calOsm高于健康狗(305mOsm/kg;302、308)。渗透压方法中等相关(P<0.0001,rs=0.46),但比例偏倚和一致性差。Cl-校正量与calOsm(P<.0001,rs=-.78)和dmOsm(P=.004,rs=-.33)呈负相关。血清碳酸氢盐浓度与Cl-呈负相关(P<0.0001,rs=-.67)。
结论:患有B期和C/D期心脏病的狗的calOsm高于健康狗。渗透压与Cl-校正量成反比,这支持了它在评估相对体内含水量方面的应用。calOsm和dmOsm之间的不良一致性阻止了方法上的交换。
BACKGROUND: Heart failure-associated hypochloremia can be depletional from diuretics or dilutional from water retention. Serum osmolality reflects water balance but has not been evaluated in dogs with heart disease.
OBJECTIVE: To determine if serum osmolality is related to heart disease stage and amount of mathematical correction of serum chloride (Cl- ) concentrations in healthy dogs and dogs with myxomatous mitral valve degeneration (MMVD).
METHODS: Seventy-seven dogs (20 healthy, 25 Stage B MMVD, 32 Stage C/D MMVD).
METHODS: Serum Cl- concentrations were mathematically corrected. Osmolality was calculated (calOsm) and directly measured by freezing point depression (dmOsm) and compared by Bland-Altman analysis. Biochemical variables and osmolality were compared among healthy, Stage B, and Stage C/D dogs. Correlations were explored between osmolality and biochemical variables. Median and range are presented. P < .05 was considered significant.
RESULTS: The calOsm was different among groups (P = .003), with Stage B (310 mOsm/kg; 306, 316) and C/D dogs (312 mOsm/kg; 308, 319) having higher calOsm than healthy dogs (305 mOsm/kg; 302, 308). Osmolality methods were moderately correlated (P < .0001, rs = .46) but with proportional bias and poor agreement. The amount of Cl- correction was negatively correlated with calOsm (P < .0001, rs = -.78) and dmOsm (P = .004, rs = -.33). Serum bicarbonate concentration was negatively correlated with Cl- (P < .0001, rs = -.67).
CONCLUSIONS: Dogs with Stage B and Stage C/D heart disease had higher calOsm than healthy dogs. Osmolality was inversely related to the amount of Cl- correction, which supports its use in assessing relative body water content. Poor agreement between calOsm and dmOsm prevents methodological interchange.