Couëtil L L, Rosenthal F S, DeNicola D B, Chilcoat C D
Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907, USA.
Am J Vet Res. 2001 Apr;62(4):538-46. doi: 10.2460/ajvr.2001.62.538.
To evaluate the association among clinical signs, results of cytologic evaluation of bronchoalveolar lavage (BAL) fluid, and measures of pulmonary function in horses with inflammatory respiratory disease.
9 healthy horses, 5 horses with inflammatory airway disease (IAD), and 9 horses with chronic obstructive pulmonary disease (COPD).
Clinical examination, lung function tests, and BAL were performed on each horse.
Standard lung mechanics of horses with exacerbated COPD differed significantly from those of healthy horses; however, there were few differences among horses with IAD, horses with COPD during remission, and healthy horses. Most variables for forced expiration (FE) in horses with COPD or IAD differed significantly from those for healthy horses. Results of clinical examination had low to moderate sensitivity and predictive values for a diagnosis of COPD (range, 67 to 80%). Results of FE tests had high sensitivity, specificity, and predictive values for a diagnosis of COPD (79 to 100%), and results of standard lung mechanics tests had low sensitivity and predictive values (22 to 69%). Percentage of neutrophils in BAL fluid was highly sensitive (100%) but moderately specific (64%) for a diagnosis of COPD.
Clinical examination is moderately accurate for establishing a diagnosis of COPD. Forced expiration tests can specifically detect early signs of airway obstruction in horses with COPD and IAD that may otherwise be inapparent. Cytologic evaluation of BAL fluid allows early detection of inflammatory respiratory disease, but it is not specific for COPD.
评估患有炎性呼吸道疾病马匹的临床体征、支气管肺泡灌洗(BAL)液的细胞学评估结果与肺功能指标之间的关联。
9匹健康马匹、5匹患有炎性气道疾病(IAD)的马匹和9匹患有慢性阻塞性肺疾病(COPD)的马匹。
对每匹马进行临床检查、肺功能测试和BAL。
病情加重的COPD马匹的标准肺力学与健康马匹有显著差异;然而,IAD马匹、处于缓解期的COPD马匹和健康马匹之间差异不大。COPD或IAD马匹的大多数用力呼气(FE)变量与健康马匹有显著差异。临床检查结果对COPD诊断的敏感性和预测值低至中等(范围为67%至80%)。FE测试结果对COPD诊断具有高敏感性、特异性和预测值(79%至100%),而标准肺力学测试结果的敏感性和预测值较低(22%至69%)。BAL液中中性粒细胞百分比对COPD诊断的敏感性高(100%)但特异性中等(64%)。
临床检查对COPD诊断具有中等准确性。用力呼气测试可特异性检测出COPD和IAD马匹气道阻塞的早期迹象,否则这些迹象可能不明显。BAL液的细胞学评估可早期检测炎性呼吸道疾病,但对COPD不具有特异性。