Carr Anthony P, Panciera David L, Kidd Linda
Small Animal Clinical Sciences, Western College of Veterinary Medicine, Saskatoon, SK, Canada.
J Vet Intern Med. 2002 Sep-Oct;16(5):504-9. doi: 10.1892/0891-6640(2002)016<0504:pffmat>2.3.co;2.
Medical records of 72 dogs diagnosed with immune-mediated hemolytic anemia (IMHA) were reviewed to find risk factors for the disease, for mortality, and for thromboembolism. Coagulation data of 32 patients were evaluated for mortality or thromboembolism risk factors. Cocker Spaniels were at increased risk for IMHA (P = .012). Timing of vaccination was not associated with development of IMHA. PCV ranged from 5 to 33%, with a mean of 16 +/- 5%. Autoagglutination was present in 42% of the dogs. Platelet counts (n = 60) varied from 3,000 to 793,000/microL (mean, 160,117 +/- 133,571; median, 144,000). Thrombocytopenia (platelet count, <200,000/microL) was present in 70% of the dogs, with severe thrombocytopenia (platelet count, <50,000/microL) being present in 22%. One-step prothrombin time (OSPT) was prolonged in 28% of the dogs tested, and activated partial thromboplastin time (APTT) was prolonged in 47% of the dogs tested. Fibrin(ogen) degradation products (FDPs) were detected in 16 of 28 dogs tested (57%). Disseminated intravascular coagulation (DIC) was diagnosed in 10 of 31 (32%) dogs and was suspected in 8 dogs. Thromboemboli were found in 20 of 25 dogs given postmortem examinations. Mortality rate was 58%. Thrombocytopenia (P = .008) and serum bilirubin concentration of >5 mg/dL (P = .015) were risk factors for mortality, and hypoalbuminemia approached significance (P = .053). Severe thrombocytopenia (P = .046), serum bilirubin concentration of >5 mg/dL (P = .038), and hypoalbuminemia (P = .016) were risk factors for thromboembolism. On evaluation of continuous data, decreased platelet count (P = .057), increased bilirubin (P = .062), and decreased albumin (P = .054) approached significance for decreased survival. A higher risk for thrombosis was found with increased alkaline phosphatase (ALKP) (P = .042), increased bilirubin (P = .047), and decreased albumin (P = .012).
回顾了72只被诊断为免疫介导性溶血性贫血（IMHA）的犬只的病历，以寻找该疾病、死亡率和血栓栓塞的危险因素。对32例患者的凝血数据进行了评估，以寻找死亡率或血栓栓塞的危险因素。可卡犬患IMHA的风险增加（P = 0.012）。疫苗接种时间与IMHA的发生无关。红细胞压积（PCV）范围为5%至33%，平均为16±5%。42%的犬只出现了自身凝集。血小板计数（n = 60）在3,000至793,000/μL之间变化（平均，160,117±133,571；中位数，144,000）。70%的犬只存在血小板减少（血小板计数<200,000/μL），22%的犬只存在严重血小板减少（血小板计数<50,000/μL）。在接受检测的犬只中，28%的犬只一步凝血酶原时间（OSPT）延长，47%的犬只活化部分凝血活酶时间（APTT）延长。在28只接受检测的犬只中，有16只（57%）检测到纤维蛋白（原）降解产物（FDPs）。在31只犬只中有10只（32%）被诊断为弥散性血管内凝血（DIC），8只犬只疑似患有DIC。在25只接受尸检的犬只中，有20只发现了血栓栓塞。死亡率为58%。血小板减少（P = 0.008）和血清胆红素浓度>5 mg/dL（P = 0.015）是死亡的危险因素，低白蛋白血症接近显著水平（P = 0.053）。严重血小板减少（P = 0.046）、血清胆红素浓度>5 mg/dL（P = 0.038）和低白蛋白血症（P = 0.016）是血栓栓塞的危险因素。在对连续数据进行评估时，血小板计数降低（P = 0.057）、胆红素升高（P = 0.062）和白蛋白降低（P = 0.054）接近影响生存率的显著水平。发现碱性磷酸酶（ALKP）升高（P = 0.042）、胆红素升高（P = 0.047）和白蛋白降低（P = 0.012）会增加血栓形成的风险。
