Costa L R, Seahorn T L, Moore R M, Taylor H W, Gaunt S D, Beadle R E
Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803, USA.
Am J Vet Res. 2000 Feb;61(2):167-73. doi: 10.2460/ajvr.2000.61.167.
To correlate clinical score, intrapleural pressure, cytologic findings of bronchoalveolar lavage fluid (BALF), and histologic lesions of pulmonary tissue in horses affected with summer pasture-associated obstructive pulmonary disease (SPAOPD).
8 adult horses affected with SPAOPD and 6 adult horses without evidence of respiratory tract disease.
Clinical score, change in intrapleural pressure (deltaPpl) during tidal breathing, results of cytologic examination and bacteriologic culture of BALF, and results of histologic examination of pulmonary parenchyma were evaluated.
Clinical scores for SPAOPD-affected horses (median, 5.75; range, 4.0 to 7.5) were significantly greater, compared with clinically normal horses (median, 2.0; range, 2.0 to 3.0). Cytologic examination of BALF from SPAOPD-affected horses revealed predominantly nondegenerate neutrophils. Histologic lesions were identified throughout pulmonary tissue and included severe accumulation of mucus and neutrophils within the small airways, metaplasia of bronchiolar goblet cells, and mild peribronchial infiltrate. Histologic examination of specimens collected via percutaneous biopsy was predictive of disease and corresponded to findings at postmortem examination. Clinical score and deltaPpl were highly correlated with mucus accumulation in the airways of affected horses. Peribronchial inflammatory infiltrate correlated with percentage of neutrophils in BALF of affected horses.
Clinical scoring and deltaPpl provided valid estimates of disease severity. Findings from cytologic examination of BALF of SPAOPD-affected horses varied, although, in most instances, it was diagnostically useful. Severe mucus accumulation in the airways was the most remarkable histopathologic finding in SPAOPD-affected horses. Examination of biopsy specimens collected from pulmonary parenchyma was consistently useful in diagnosing SPAOPD.
将夏季牧场相关阻塞性肺病（SPAOPD）患马的临床评分、胸腔内压、支气管肺泡灌洗液（BALF）的细胞学检查结果及肺组织的组织学病变进行关联分析。
8匹患SPAOPD的成年马和6匹无呼吸道疾病迹象的成年马。
评估临床评分、潮式呼吸期间胸腔内压变化（deltaPpl）、BALF的细胞学检查和细菌培养结果以及肺实质的组织学检查结果。
与临床正常马（中位数为2.0；范围为2.0至3.0）相比，患SPAOPD马的临床评分（中位数为5.75；范围为4.0至7.5）显著更高。对患SPAOPD马的BALF进行细胞学检查，结果显示主要为未退化的中性粒细胞。在整个肺组织中均发现了组织学病变，包括小气道内严重的黏液和中性粒细胞积聚、细支气管杯状细胞化生以及轻度支气管周围浸润。经皮活检采集标本的组织学检查可预测疾病，且与尸检结果相符。临床评分和deltaPpl与患马气道内的黏液积聚高度相关。支气管周围炎性浸润与患马BALF中中性粒细胞百分比相关。
临床评分和deltaPpl可有效评估疾病严重程度。对患SPAOPD马的BALF进行细胞学检查的结果各异，不过在大多数情况下具有诊断价值。气道内严重的黏液积聚是患SPAOPD马最显著的组织病理学发现。对肺实质采集的活检标本进行检查在诊断SPAOPD方面始终具有重要作用。
