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感染性心内膜炎犬的临床病理特征及预后:71例病例(1992 - 2005年)

Clinicopathologic findings and outcome in dogs with infective endocarditis: 71 cases (1992-2005).

作者信息

Sykes Jane E, Kittleson Mark D, Chomel Bruno B, Macdonald Kristin A, Pesavento Patricia A

机构信息

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.

出版信息

J Am Vet Med Assoc. 2006 Jun 1;228(11):1735-47. doi: 10.2460/javma.228.11.1735.

Abstract

OBJECTIVES

To evaluate clinical, laboratory, and necropsy findings in dogs with infective endocarditis (IE).

DESIGN

Retrospective case series.

ANIMALS

71 dogs with possible or definite IE.

PROCEDURES

Medical records were reviewed for signalment, clinical features, and results of clinicopathologic testing and diagnostic imaging. Yearly incidence and the effect of variables on survival were determined by use of survival curve analysis.

RESULTS

The overall incidence of IE was 0.05%. Most affected dogs were of large breeds, and > 75% were older than 5 years. The aortic valve was affected in 36 of the 71 (51%) dogs, and the mitral valve was affected in 59%. Lameness caused by immune-mediated polyarthritis, septic arthritis, or peripheral arterial thromboembolism was observed in 53% of the dogs. Neurologic complications were diagnosed in 17 of 71 (24%) dogs. Thromboembolic disease was suspected in 31 of 71 (44%) of dogs. The mortality rate associated with IE was 56%, and median survival time was 54 days. Factors negatively associated with survival included thrombocytopenia, high serum creatinine concentration, renal complications, and thromboembolic complications.

CONCLUSIONS AND CLINICAL RELEVANCE

A diagnosis of IE should be suspected in dogs with fever, systolic or diastolic murmur, and locomotor problems. Dogs with thrombocytopenia, high serum creatinine concentration, thromboembolism, or renal complications may have a shorter survival time.

摘要

目的

评估感染性心内膜炎(IE)犬的临床、实验室及尸检结果。

设计

回顾性病例系列研究。

动物

71只可能患有或确诊患有IE的犬。

方法

查阅病历,了解动物的特征、临床症状、临床病理检查及诊断性影像学检查结果。采用生存曲线分析确定IE的年发病率及各变量对生存的影响。

结果

IE的总体发病率为0.05%。大多数患病犬为大型犬,超过75%的犬年龄大于5岁。71只犬中有36只(51%)主动脉瓣受累,二尖瓣受累的犬占59%。53%的犬出现由免疫介导的多关节炎、化脓性关节炎或外周动脉血栓栓塞引起的跛行。71只犬中有17只(24%)被诊断出有神经系统并发症。71只犬中有31只(44%)怀疑有血栓栓塞性疾病。与IE相关的死亡率为56%,中位生存时间为54天。与生存呈负相关的因素包括血小板减少、血清肌酐浓度升高、肾脏并发症和血栓栓塞并发症。

结论及临床意义

对于出现发热、收缩期或舒张期杂音及运动问题的犬,应怀疑患有IE。血小板减少、血清肌酐浓度升高、血栓栓塞或有肾脏并发症的犬生存时间可能较短。

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